【摘要】：目的：觀察選擇性頸段脊神經(jīng)后根切斷術治療腦性癱瘓患者上肢痙攣的療效。 方法：2008年5月至2013年6月,20例腦癱上肢痙攣患者接受選擇性頸段脊神經(jīng)后根切斷術治療,其中男14例,女6例；年齡8～22歲。手術方式為按一定節(jié)段,以一定比例將神經(jīng)刺激儀刺激后閾值低的神經(jīng)后根小束切斷。術后第一天(無明顯并發(fā)癥者)即開始上肢的關節(jié)活動、肌力訓練,術后2周拆線并行系統(tǒng)的康復訓練,上肢以作業(yè)療法(OT)訓練為主。手術前后分別對肌張力、粗大運動功能(GMFM-88)、精細運動能力(FMFM)、功能獨立性(FIM)進行評分 結(jié)果：20例均獲得術后6個月復診,術前、術后兩周及術后6個月的肌張力評分分別為4.20±0.41,1.50±0.60,1.60±0.59,術前、術后6個月GMFM-88評分分別為128.25±24.42,171.75±20.85；術前、術后6個月的FMFM評分分別為58.15±9.95,84.80±14.29；術前及術后6個月FIM評分分別為61.35±16.82,77.45±15.41；術后6個月患者的肌張力、粗大運動功能、精細運動能力和日常生活功能獨立性均有改善(P0.01) 結(jié)論：選擇性頸段脊神經(jīng)后根切斷術能降低患者的肌張力、緩解痙攣,能提高患者的運動功能和日常生活能力,治療腦癱上肢痙攣的短期療效肯定,遠期療效需進一步觀察。
[Abstract]:Objective: to observe the effect of selective posterior rhizotomy of cervical spinal nerve on upper limb spasm in patients with cerebral palsy. Methods: from May 2008 to June 2013, 20 patients with upper limb spasm of cerebral palsy were treated with selective posterior rhizotomy of cervical spinal nerve, including 14 males and 6 females, aged 822 years. The method of operation was to cut the nerve posterior root bundles with low threshold after stimulation with a certain proportion according to a certain segment. On the first day of operation (without obvious complications), the joint movement and muscle strength training of the upper extremities were started, and the rehabilitation training was performed 2 weeks after the operation. The main training of the upper extremities was the (OT) training of occupational therapy. Muscle tension, gross motor function (GMFM-88), fine motor ability (FMFM),) functional independence (FIM) were evaluated before and after operation. The results showed that 20 cases were re-diagnosed 6 months after operation. The muscular tension score was 4.20 鹵0.41 鹵1.50 鹵0.601.60 鹵0.59 at two weeks after operation and six months after operation, and the GMFM-88 score was 128.25 鹵24.42171.75 鹵20.85 at 6 months before and 6 months after operation, and the FMFM score was 58.15 鹵9.95 鹵84.80 鹵14.29 before and 6 months after operation, respectively, and the FIM score was 61.35 鹵16.82 鹵77.45 鹵15.41 before and 6 months after operation. 6 months after operation, muscle tension, coarse motor function, fine motor ability and independence of daily living function were all improved (P0.01). Conclusion: selective posterior rhizotomy of cervical spinal nerve can reduce muscle tension and relieve spasm. It can improve the motor function and daily life ability of the patients, and the short-term curative effect of treating cerebral palsy upper limb spasm is certain, and the long-term effect needs further observation.
【學位授予單位】：北京中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R742.3

【參考文獻】

相關期刊論文 前10條

1 朱默;史惟;;兒童功能獨立檢查量表的研究及應用[J];中國兒童保健雜志;2006年05期

2 劉雅麗,高偉;痙攣的評定[J];國外醫(yī)學(物理醫(yī)學與康復學分冊);2003年02期

3 廖元貴;史惟;紀樹榮;;能力低下兒童評定量表及其應用[J];國外醫(yī)學(物理醫(yī)學與康復學分冊);2005年04期

4 馬丙祥;小兒腦性癱瘓的中醫(yī)辨證治療[J];湖北中醫(yī)雜志;1997年02期

5 朱梅;馬丙祥;琚瑋;鄭宏;;小兒腦性癱瘓中醫(yī)證候初步探討[J];中國實用神經(jīng)疾病雜志;2009年14期

6 謝劍平;石海燕;雷巧容;;口服巴氯芬配合康復訓練治療痙攣型腦癱臨床觀察[J];中外醫(yī)療;2011年04期

7 陳桃秀;吳瑛;蒙群利;;穴位注射配合功能訓練治療小兒腦癱療效觀察[J];遼寧中醫(yī)雜志;2009年07期

8 林志;陳慧;陳志光;;鼠神經(jīng)生長因子治療對小兒腦癱運動功能的影響[J];海峽藥學;2012年10期

9 郭鵬;;穴位注射治療缺氧缺血性腦病降低小兒腦癱發(fā)生率療效觀察[J];四川中醫(yī);2009年01期

10 任月林;任旭飛;;針刀調(diào)整電生理線路治療痙攣型腦癱的臨床研究報告[J];世界科學技術;2006年04期

，

本文編號：2155472