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目的分析A型肉毒素治疗双下肢痉挛性脑瘫患儿的临床效果及对痉挛肌改良版Ashworth评分(MAS)影响。方法选取双下肢痉挛性脑瘫患儿83例,按照不同治疗方案分为观察组47例和对照组36例,观察组行A型肉毒素治疗,对照组行常规性康复训练治疗,比较2组危重症病情评分(PRS)、MAS评分、内收肌角、日常生活能力评分(ADL)。结果观察组PRS各项评分均明显高于对照组,差异有统计学意义(P<0.01)。2组治疗后1周、1个月MAS评分均较治疗前明显改善,且观察组改善程度优于对照组,差异均有统计学意义(P<0.01)。治疗后2组内收肌角、ADL评分均较治疗前明显改善,且观察组改善程度优于对照组,差异均有统计学意义(P<0.01)。结论 A型肉毒素治疗双下肢痉挛性脑瘫患儿能提高其运动能力,有效缓解肌群痉挛状况,提高日常生活能力,值得临床推广应用。
Objective To analyze the clinical effect of botulinum toxin type A in the treatment of children with spastic cerebral palsy of both lower extremities and the modified Ashworth score (MAS) on the spastic muscle. Methods A total of 83 children with spastic cerebral palsy of lower extremity were selected and divided into observation group (n = 47) and control group (n = 36) according to different treatment regimen. The observation group received type A botulinum toxin treatment and the control group received routine rehabilitation training. Severe illness score (PRS), MAS score, adducting angle, daily living ability score (ADL). Results All the scores of PRS in the observation group were significantly higher than those in the control group (P <0.01). The scores of MAS at 1 week and 1 month after treatment in both groups were significantly improved compared with that before treatment, and the improvement in observation group was better than that in control group (P <0.01). After treatment, the adduct angle and ADL score of two groups were significantly improved compared with that before treatment, and the improvement in observation group was better than that in control group (P <0.01). Conclusion A botulinum toxin treatment for children with spastic cerebral palsy of both lower extremities can improve their motor ability, relieve muscle spasm and improve their daily living ability, which is worthy of clinical application.