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超声联合电刺激引导下A型肉毒毒素注射对卒中早期患者肌痉挛的临床研究

  

  1. 苏州大学附属第一医院  康复科,江苏 苏州 215006
  • 出版日期:2016-12-05 发布日期:2016-12-01
  • 通讯作者: 通信作者:张大伟,Email: zhangdwmedical@163.com

Clinical research on injection of botulinum toxin type A by ultrasound combined with electrical stimulation guided for treatment of spasticity to early stroke  patients

  1. Department of Rehabilitation,the First Affiliated Hospital of Soochow Uuniversity, Suzhou  215006,China
  • Online:2016-12-05 Published:2016-12-01
  • Contact: Corresponding author: Zhang Dawei,Email: zhangdwmedical@163.com

摘要: 目的观察超声联合电刺激引导下A型肉毒毒素(BTXA)注射对早期脑血管意外患者肌痉挛的影响。方法选取早期脑血管意外后小腿肌痉挛患者46例,随机分为治疗组(23例)及对照组(23例)。对照组给予常规康复训练,治疗组在常规康复训练基础上辅以超声联合电刺激引导下BTXA注射治疗。于治疗前和治疗6周后分别采用改良Ashworth量表(MAS)、简化FuglMeyer量表(FMA)、世界卫生组织生存质量量表简表(WHOQOLBREF)、表面肌电积分值(iEMG)对2组功能进行评定。结果经6周治疗后,治疗组较对照组改善,治疗组MAS、 FMA、WHOQOLBREF、iEMG评分显著高于对照组(P<0.05)。结论超声联合电刺激引导下A型肉毒毒素注射对早期脑卒中患者肌痉挛定位准确、安全有效。

关键词: 脑血管意外, A型肉毒毒素, 肌痉挛, 超声, 电刺激

Abstract: ObjectiveTo observe the effect of ultrasound combined with electrical stimulation guided injection of botulinum toxin type A(BTXA)for the treatment of spasticity in early cerebral vascular accident patients. MethodsFortysix early cerebral vascular accident patients with lower limb spasticity were divided randomly into two groups: treatment  group(23 patients)  and control group(23 patients).Patients in control group got routine rehabilitation training, and those in treatment group were given ultrasound combined with electrical stimulation guided injection of botulinum toxin type A additionally. The functions of two groups were evaluated by using the modified Ashworth scale(MAS),FuglMeyer assessment(FMA),intergrated electromyography(iEMG),WHO Quality of LifeBREF(WHOQOLBREF)  before and six weeks after treatment. ResultsAfter six weeks of treatment, the treatment group improved much better than the control group. The average MAS,FMA,WHOQOLBREF,iEMG score in treatment group were significantly higher than those  of control group(P<0.05).ConclusionUltrasound combined with electrical stimulation guided injection of botulinum toxin type A for the treatment of spasticity in early cerebral vascular accident patients is effective, accurate and safe.

Key words: cerebral vascular accident, botulinum toxin type A, spasticity, ultrasound, electrical stimulation