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目的探讨A型肉毒素和丙戊酸钠对脑卒中伴上肢痉挛患者生存质量的影响。方法将288例伴有上肢痉挛的脑卒中患者随机分为A型肉毒素治疗组、丙戊酸钠治疗组和对照组各96例。对照组给予常规治疗及康复训练;A型肉毒素治疗组在对照组治疗基础上对痉挛的上肢肱二头肌、前臂屈肌群的肌腹等进行A型肉毒素分点注射;丙戊酸钠治疗组在对照组治疗基础上给予口服丙戊酸钠600mg/d,共10周。分别于治疗前及治疗10周后采用改良Fugl-Meyer肢体综合功能评分量表评定患者运动功能,WHO生存质量测定表评定患者生存质量。结果治疗后A型肉毒素和丙戊酸钠治疗组Fugl-Meyer、WHO生存质量测定表评分(68.41±7.54)、(66.79±7.46)分均高于对照组(58.99±6.23)分(P<0.05)。结论 A型肉毒毒素可降低脑卒中患者痉挛上肢的肌张力,增加其功能性活动能力;丙戊酸钠有利于脑卒中患者心理、躯体、社会功能的康复;2种治疗方法均可改善脑卒中患者生存质量。
Objective To investigate the effects of botulinum toxin type A and sodium valproate on the quality of life in stroke patients with upper extremity spasticity. Methods A total of 288 stroke patients with upper extremity spasticity were randomly divided into type A botox group, sodium valproate group and control group with 96 cases each. The control group was given routine treatment and rehabilitation training. Botulinum toxin type A group was injected botulinum toxin type A on the basis of the treatment of the control group, and botulinum toxin type A was given to the upper limb biceps and sprain of forearm flexor group. Valproate Sodium treatment group was given oral sodium valproate 600mg / d on the basis of the control group for 10 weeks. The motor function of the patients was assessed by modified Fugl-Meyer physical comprehensive functional rating scale before treatment and after 10 weeks of treatment, and the WHO quality of life measurement table was used to evaluate the quality of life of patients. Results The scores of Fugl-Meyer and WHO (68.41 ± 7.54) and (66.79 ± 7.46) points after treatment with botulinum toxin A and sodium valproate in treatment group were significantly higher than those in control group (58.99 ± 6.23) (P < 0.05). Conclusion Botulinum toxin type A can reduce the muscle tone of the spastic upper limbs in stroke patients and increase its functional activity. Sodium valproate is beneficial to the rehabilitation of psychological, physical and social functions in patients with stroke. Both treatments can improve brain function Quality of life in stroke patients.