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目的观察针刀微创治疗痉挛型脑瘫患儿双下肢运动功能障碍的临床疗效。方法将54例痉挛型脑瘫患儿按就诊顺序随机分为对照组和治疗组各27例,2组患儿均接受常规康复治疗,治疗组在常规康复治疗的基础上配合针刀微创技术对患儿双下肢进行切割松解。每月1次,3次为1个疗程,连续治疗2个疗程。比较治疗前后及随访1年3个时间段的腓肠肌肌张力评分、足背屈角及粗大运动功能量表(GMFM)评分。结果治疗后及随访1年,2组腓肠肌肌张力评分及足背屈角均较同组治疗前显著降低,GMFM评分显著升高,差异有统计意义(P<0.05或P<0.01);2组治疗后及随访1年比较,治疗组腓肠肌肌张力评分及足背屈角显著低于对照组,GMFM评分显著高于对照组,2组比较差异有统计意义(P<0.05或P<0.01)。结论针刀微创技术配合常规康复训练治疗痉挛型脑瘫患儿双下肢运动功能障碍能够迅速取得显著的疗效,同时针刀微创治疗简便、安全,值得在临床中推广应用。
Objective To observe the clinical effect of acupotome minimally invasive treatment of motor dysfunction of both lower limbs in children with spastic cerebral palsy. Methods Fifty-four children with spastic cerebral palsy were randomly divided into control group and treatment group with 27 cases in each group. The two groups received routine rehabilitation. The treatment group was treated with needle-knife minimally invasive technique on the basis of routine rehabilitation Children with lower extremity cut loose. Once a month, 3 times for a course of treatment, continuous treatment 2 courses. Gastrocnemius muscle tone, dorsiflexion, and gross motor function scale (GMFM) were compared before and after treatment and at 1 year follow-up. Results After treatment and 1 year follow-up, the muscular tension scores and dorsiflexion angle of gastrocnemius muscle in both groups were significantly lower than those before treatment, and the GMFM scores were significantly increased (P <0.05 or P <0.01) After treatment and 1 year follow-up, the gastrocnemius muscle tone and dorsiflexion angle of the treated group were significantly lower than those of the control group, and the GMFM score was significantly higher than that of the control group. There was significant difference between the two groups (P <0.05 or P <0.01). Conclusion The minimally invasive acupuncture combined with conventional rehabilitation training for children with spastic cerebral palsy can rapidly obtain significant curative effect of motor dysfunction in both lower extremities. At the same time, the minimally invasive acupuncture treatment is simple and safe and should be widely applied in clinical practice.