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目的观察选择性周围神经部分切断术治疗痉挛性脑瘫的效果。方法采用显微神经外科手术治疗的68例痉挛型脑瘫病例,根据患者肢体痉挛的不同情况采用相应的选择性周围神经部分切断术,包括胫神经、坐骨神经和正中神经,其中选择性胫神经切断术36侧,选择性正中神经切断术28侧,选择性坐骨神经切断术28侧,共计92侧。结果全部患者经3-15个月的随访,术后即刻肢体痉挛状态缓解率为97.8%(90/92),随访期间为94.6%(87/92),随访期间运动功能改善率为76.5%(52/68),术后肢体痉挛状态不同程度复发5侧(5.4%)。结论选择性周围神经部分切断术对降低痉挛性脑瘫患者肌张力、纠正痉挛性畸形近期疗效满意,手术创伤小,治疗效果能够被医患双方同时认可。
Objective To observe the effect of selective peripheral partial neurotomy on spastic cerebral palsy. Methods Seventy-eight cases of spastic cerebral palsy treated by microsurgical neurosurgery were treated with selective partial peripheral partial neurotomy, including the tibial nerve, sciatic nerve and median nerve, according to the different conditions of limb spasticity. Among them, selective tibial nerve transection 36 sides, selective median nerve resection 28 sides, selective sciatic nerve resection 28 sides, a total of 92 sides. Results All patients were followed up for 3-15 months. The rate of limb spasm remission was 97.8% (90/92) and 94.6% (87/92) during follow-up. The improvement rate of motor function during follow-up was 76.5% 52/68). Postoperative limb spasticity was relapsed to 5 degrees (5.4%). Conclusions Selective peripheral partial neurotomy can reduce the muscle tension of spastic cerebral palsy patient and correct the short-term curative effect of spastic deformity. The surgical trauma is small and the therapeutic effect can be recognized by both doctors and patients at the same time.