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目的 观察局部肌肉注射A型肉毒毒素 (BTX A)治疗痉挛型脑性瘫痪的疗效。方法 于 2 0 0 1年 5月至 2 0 0 3年 9月 ,用BTX A对 73例痉挛型脑性瘫痪的患儿进行局部肌肉注射 ,其中男性 5 2例 ,女性 2 1例。年龄1 6～ 15 (10 4± 2 5 )岁。以改良阿氏量表 (MAS)评定肌张力 ,以运动评价量表 (PRS)评定运动功能。分析治疗前、治疗后 4周及治疗后 3个月的肌张力、PRS评分改变情况 ,并随访治疗后BTX A产生疗效时间及副反应。结果 BTX A治疗前、治疗后 4周及治疗后 3个月肌张力、PRS评分有明显改善。治疗后 4周 ,PRS各项评分均有明显改善 (P <0 0 5 ) ,其中步态、关节弯曲度改善最明显 (P <0 0 0 1)。 4 8例 (6 6 % )患儿在治疗 2～ 3d出现疗效。副反应短暂、轻微 ,无全身副反应。结论 局部肌肉注射BTX A能够安全地治疗痉挛型脑性瘫痪 ,有效改善步态、提高行走能力
Objective To observe the efficacy of topical intramuscular injection of botulinum toxin type A (BTX A) in the treatment of spastic cerebral palsy. Methods From May 2001 to September 2003, 73 children with spastic cerebral palsy were injected intramuscularly with BTX A, including 52 males and 21 females. Age 16 ~ 15 (10 4 ± 2 5) years old. Muscular tone was assessed using the Modified Aleuhand Scale (MAS), and motor function assessed using the Sport Assessment Scale (PRS). Pretreatment, 4 weeks after treatment and 3 months after treatment, muscle tone, PRS score changes, and follow-up treatment of BTX A effect time and side effects. Results Before BTX A treatment, 4 weeks after treatment and 3 months after treatment, muscle tone and PRS score were significantly improved. After 4 weeks of treatment, all the scores of PRS were significantly improved (P <0.05), of which gait and joint curvature were the most obvious improvement (P <0.01). Forty-eight cases (66%) had therapeutic effect in 2 ~ 3d days. Side effects of short, mild, no systemic side effects. Conclusion Local intramuscular injection of BTX A can safely treat spastic cerebral palsy, effectively improve gait and improve walking ability