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目的:探讨A型肉毒毒素对痉挛型脑性瘫痪拇指内收畸形患者拇指腕掌外展活动度及痉挛的改善作用。方法:50例脑性瘫痪患儿按随机数字表法分为治疗组和对照组,治疗组采用A型肉毒毒素肌肉注射和手传统中医按摩、拇指矫形器固定及上田法训练,对照组采用手传统中医按摩、拇指矫形器固定和上田法训练。结果:经过3个月治疗,治疗组与对照组各50只手中,治疗组:显效23只,有效25只,无效2例;对照组:显效12例,有效27例,无效11例。治疗组治疗效果明显优于对照组(χ2=7.16,P<0.01),且治疗组拇指腕掌外展活动度(治疗后:41.88O±7.91O)明显改善,与对照组(治疗后:33.30O±8.56O)相比,差异有显著性意义(t=5.20,P<0.01)。结论:A型肉毒毒素肌肉注射能显著改善脑性瘫痪拇指内收畸形患儿的关节活动度及痉挛程度。
OBJECTIVE: To investigate the effect of botulinum toxin type A on the improvement of spina bifurcation degree of thumb and wrist in patients with spina bifida flexion cerebral infarction. Methods: Fifty children with cerebral palsy were randomly divided into treatment group and control group according to random number table. The treatment group received intramuscular injection of botulinum toxin type A, traditional Chinese medicine massage with thumb, orthosis of thumb and orthodontic training, and control group Hand traditional Chinese massage, thumb orthosis and Ueda training. Results: After three months of treatment, the treatment group and the control group of 50 hands, the treatment group: markedly effective 23, effective 25, invalid 2; control group: markedly effective in 12 cases, effective in 27 cases, ineffective in 11 cases. The curative effect of the treatment group was significantly better than that of the control group (χ2 = 7.16, P <0.01), and the degree of abduction of the thumb wrist of the treatment group (41.88 ± 7.91O after treatment) was significantly improved. Compared with the control group O ± 8.56O), the difference was significant (t = 5.20, P <0.01). Conclusion: Intramuscular injection of botulinum toxin type A can significantly improve the degree of joint mobility and degree of spasticity in children with cerebral palsy and thumb adduction deformity.