| 选择性脊神经后根切断术改善脑瘫患者痉挛及粗大运动的临床观察 |
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投稿时间：2019-06-25
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| 作者 | Author | 单位 | Address | E-Mail |
| 徐杰 |
XU Jie |
北京中医药大学东直门医院骨四科, 北京 100700 |
The Fourth Department of Orthopaedics, Dongzhimen Hospital, Beijing University of Traditional Chinese Medicine, Beijing 100700, China |
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| 徐林 |
XU Lin |
北京中医药大学东直门医院骨四科, 北京 100700 |
The Fourth Department of Orthopaedics, Dongzhimen Hospital, Beijing University of Traditional Chinese Medicine, Beijing 100700, China |
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| 曾杰 |
ZENG Jie |
北京中医药大学东直门医院骨四科, 北京 100700 |
The Fourth Department of Orthopaedics, Dongzhimen Hospital, Beijing University of Traditional Chinese Medicine, Beijing 100700, China |
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| 杨兴奎 |
YANG Xing-kui |
西安中医脑病医院外科, 西安 710032 |
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| 李召辉 |
LI Zhao-hui |
西安中医脑病医院外科, 西安 710032 |
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| 邵高凯 |
SHAO Gao-kai |
西安中医脑病医院外科, 西安 710032 |
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| 李筱叶 |
LI Xiao-ye |
北京中医药大学东直门医院骨四科, 北京 100700 |
The Fourth Department of Orthopaedics, Dongzhimen Hospital, Beijing University of Traditional Chinese Medicine, Beijing 100700, China |
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| 邓博文 |
DENG Bo-wen |
北京中医药大学东直门医院骨四科, 北京 100700 |
The Fourth Department of Orthopaedics, Dongzhimen Hospital, Beijing University of Traditional Chinese Medicine, Beijing 100700, China |
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| 穆晓红 |
MU Xiao-hong |
北京中医药大学东直门医院骨四科, 北京 100700 |
The Fourth Department of Orthopaedics, Dongzhimen Hospital, Beijing University of Traditional Chinese Medicine, Beijing 100700, China |
mxh_2004@163.com |
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| 期刊信息：《中国骨伤》2019年，第32卷，第9期，第815-819页 |
| DOI：10.3969/j.issn.1003-0034.2019.09.008 |
| 基金项目:国家自然科学基金（编号：81874467） |
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| 中文摘要:目的：探究腰骶段选择性脊神经后根切断术（SPR）对脑瘫患者的下肢痉挛状态及粗大运动功能的改善情况。方法：回顾性分析2018年1月至2018年10月分别采用单纯康复治疗和腰骶段选择性脊神经后根切断术结合康复治疗脑瘫患者共47例，根据是否行腰骶段选择性脊神经后根切断术手术治疗分为A组和B组，A组则采用康复结合腰骶段选择性脊神经后根切断术治疗，B组采用单纯康复治疗。其中A组23例，男15例，女8例，年龄（7.30±3.25）岁；B组24例，男13例，女11例，年龄（7.00±3.09）岁。治疗前后对47例患者进行改良的Ashworth（MAS）评级及粗大运动功能评定量表（GMFM-88项）评分。对比治疗前后患者MAS分级及GMFM-88项评分变化以评价两组患者痉挛程度及粗大运动功能改善情况。结果：47例患者均得到随访。治疗后6个月两组患者MAS分级较治疗前均明显改善（P<0.05），且A组较B组改善更明显（P<0.05）。治疗后6个月两组患者GMFM-88项D区、E区及总分较治疗前明显改善（P<0.05），A组D区及总分较B组改善更明显，两组在E区的改善情况差异无统计学意义。结论：选择性脊神经后根切断术结合康复改善脑瘫患者下肢痉挛状态及粗大运动功能效果明显，能够有效促进脑瘫患者下肢运动功能重建及恢复。 |
| 【关键词】脊神经根切断术 脑性瘫痪 痉挛 粗大运动功能 |
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| Clinical observation of selective posterior rhizotomy for improving spasticity and gross movement in patients with cerebral palsy |
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ABSTRACT
Objective:To explore the effect of selective lumbosacral posterior rhizotomy(SPR) on lower limb spasticity and gross motor function in patients with cerebral palsy.
Methods:From January 2018 to October 2018,47 patients with cerebral palsy were treated with rehabilitation alone and SPR combined with rehabilitation. According to whether SPR was performed,the patients were divided into group A and group B. Group A was treated with rehabilitation combined with SPR at lumbosacral level,and group B was treated with rehabilitation alone. There were 23 cases in group A,including 15 males and 8 females,with an average age of (7.30±3.25) years old; 24 cases in group B,13 males and 11 females,with an average age of (7.00±3.09) years old. Forty-seven patients were assessed with modified Ashworth(MAS) and Gross Motor Function Scale(GMFM-88 items) before and after treatment. The changes of MAS and GMFM-88 scores before and after treatment were compared to evaluate the degree of spasm and the improvement of gross motor function in the two groups.
Results:All 47 patients were followed up. At 6 months after treatment,the MAS classification of the two groups was significantly improved(P<0.05),and the improvement of group A was more obvious than that of group B(P<0.05). Six months after treatment,the D,E and total scores of GMFM-88 between two groups were significantly improved compared with those before operation(P<0.05). The improvement of D and total scores in group A was more obvious than that in group B. There was no significant difference in the improvement of area E between two groups.
Conclusion:Selective posterior rhizotomy combined with rehabilitation can significantly improve the spastic state and gross motor function of lower limbs in children with cerebral palsy,and can effectively promote the reconstruction and recovery of motor function of lower limbs in children with cerebral palsy. |
| KEY WORDS Rhizotomy Cerebral palsy Spasm Gross motor function |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 徐杰,徐林,曾杰,杨兴奎,李召辉,邵高凯,李筱叶,邓博文,穆晓红.选择性脊神经后根切断术改善脑瘫患者痉挛及粗大运动的临床观察[J].中国骨伤,2019,32(9):815~819 |
| 英文格式: | XU Jie,XU Lin,ZENG Jie,YANG Xing-kui,LI Zhao-hui,SHAO Gao-kai,LI Xiao-ye,DENG Bo-wen,MU Xiao-hong.Clinical observation of selective posterior rhizotomy for improving spasticity and gross movement in patients with cerebral palsy[J].zhongguo gu shang / China J Orthop Trauma ,2019,32(9):815~819 |
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