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目的:探讨超声评定小腿三头肌(比目鱼肌、腓肠肌)对轻中度痉挛型双瘫脑性瘫痪(脑瘫)儿童康复疗效的评价,提供一种新的康复评价手段。方法:选取30名具备独立行走能力的轻中度痉挛型双瘫脑瘫患儿,随机分为2组:观察组15例进行痉挛肌治疗仪联合常规康复训练治疗;对照组15例仅进行常规康复训练治疗。使用改良Ashworth(MAS)评定、足印法步态分析、B超测定比目鱼肌(SoL)厚度与腓肠肌中部(GMM)厚度。结果:(1)治疗1.5个月与治疗前比较:2组分别与治疗前比较,MAS分值略有降低,但无显著性差异(P>0.05);步态分析值明显增加,有显著性差异(P<0.05);SoL值明显增加,有显著性差异(P<0.05);GMM值明显增加,有显著性差异(P<0.05)。(2)治疗3个月与治疗前比较:2组分别与治疗前比较,MAS分值明显降低(P<0.05);步态分析值明显增加,(P<0.01);SoL值明显增加(P<0.01);GMM值明显增加(P<0.01)。(3)2组比较:治疗前2组的MAS分值、步态分析值、SoL值、GMM值比较均无显著性差异(P>0.05);治疗3个月后2组的MAS分值、步态分析值、SoL值、GMM值比较均有显著性差异(P<0.05);(4)相关性分析:观察组治疗前、治疗1.5个月、治疗3个月后步态分析值分别与SoL值、GMM值具有相关性(步行足长/立位足长比与SoL值r=0.623,P<0.01;步行足长/立位足长比与GMM值r=0.418,P<0.01)。结论:B超可以通过反映局部肌肉厚度变化,为脑瘫患儿的疗效评价提供客观依据;
Objective: To evaluate the evaluation of rehabilitation efficacy of triceps brachii (soleus, gastrocnemius) in children with mild to moderate spastic cerebral palsy (cerebral palsy) by ultrasound and to provide a new means of rehabilitation evaluation. Methods: Thirty children with mild to moderate spastic bipolar cerebral palsy who had independent walking ability were randomly divided into 2 groups: 15 cases in the observation group were treated with spasmodic muscle massaging apparatus and conventional rehabilitation training; 15 cases in the control group were only routinely recovered Training and treatment. The modified Ashworth (MAS) assessment, footprinting gait analysis, and B ultrasound were used to measure the thickness of soleus muscle (SoL) and central gastrocnemius muscle (GMM). Results: (1) Compared with before treatment, the score of MAS was slightly lower than that of before treatment in two groups (P> 0.05), while the value of gait analysis was significantly increased (P <0.05). The value of SoL increased significantly, with significant difference (P <0.05). The GMM increased significantly with a significant difference (P <0.05). (2) After treatment for 3 months, the score of MAS was significantly lower than that before treatment (P <0.05); the value of gait analysis was significantly increased (P <0.01); the value of SoL was significantly increased <0.01); GMM increased significantly (P <0.01). (3) There were no significant differences in MAS score, gait analysis value, SoL value and GMM value between the two groups before treatment (P> 0.05). After 3 months of treatment, the MAS score, (4) Correlation analysis: The observation group before treatment, the treatment of 1.5 months, 3 months after treatment, the gait analysis of the value of SoL and GMM (r = 0.623, r = 0.623, P <0.01; r = 0.418, r = 0.418, P <0.01). Conclusion: B ultrasound can reflect the change of local muscle thickness and provide an objective basis for evaluating the curative effect of children with cerebral palsy.