A型肉毒毒素注射對腦卒中上肢屈肌痙攣的影響
發(fā)布時間：2018-11-17 09:06
【摘要】：目的： 觀察A型肉毒毒素注射對腦卒中患者上肢痙攣狀態(tài)的影響，探討肌張力的改變與上肢運功功能及日常生活活動能力的關(guān)系。方法： 選取腦卒中患者40例，隨機分為治療組和對照組，治療組患者給予A型肉毒毒素注射后進(jìn)行常規(guī)康復(fù)治療，對照組患者僅進(jìn)行常規(guī)康復(fù)治療。在治療前和治療2周后、6周后、12周后進(jìn)行評價，采用改良Barthel指數(shù)(Modified Barthel index，MBI)中與上肢運動有關(guān)的項目(包括進(jìn)食、修飾、沐浴、穿衣和如廁)以評定患者日常生活活動(Activities of daily living， ADL)能力；采用簡易Fugl-Meyer量表（Fugl-Meyer assessment scale，F(xiàn)MA)中上肢部分評定患者上肢運動功能；采用改良Ashworth量表(Modified Ashworth scale，MAS)評定患者肌痙攣程度。結(jié)果： 治療組患者治療2周后MAS評分與治療前相比，差異有統(tǒng)計學(xué)意義，與對照組比較，差異顯著，具有統(tǒng)計學(xué)意義，F(xiàn)MA與MBI評分較治療前有提高，但與對照組比較無統(tǒng)計學(xué)意義。治療6周后及12周后，治療組MAS評分、MBI、FMA評分較治療前差異均有統(tǒng)計學(xué)意義，與對照組比較，差異具有統(tǒng)計學(xué)意義，提示治療組日常生活活動能力及肢體運功功能提高更為明顯。對照組MAS評分、MBI、FMA評分在治療后2周后與治療前比較差異無統(tǒng)計學(xué)意義，治療后6周后及12周后提高顯著，差異均有統(tǒng)計學(xué)意義，說明常規(guī)治療可以改善痙攣狀態(tài)，提高上肢運功功能及提高日常生活活動能力，但顯效較為緩慢，需要6周以上康復(fù)治療，運動功能和日常生活活動能力才有提高。結(jié)論: 肉毒毒素注射可以快速有效并持續(xù)的降低肌張力，改善痙攣狀態(tài)，結(jié)合康復(fù)治療，可明顯提高日常生活活動能力及肢體運功功能。在時效方面，痙攣減輕在注射后第2周即顯效，第6周時趨于穩(wěn)定，藥效可持續(xù)至治療12周后。
[Abstract]:Objective: to observe the effect of botulinum toxin A injection on the spasticity of upper extremities in stroke patients and to explore the relationship between muscle tension and the function of upper limb motility and activities of daily living. Methods: forty patients with stroke were randomly divided into two groups: the treatment group and the control group. The patients in the treatment group were given routine rehabilitation therapy after botulinum toxin A injection, while the patients in the control group were treated with conventional rehabilitation therapy only. Items related to upper limb movement (including eating, grooming, bathing) in the modified Barthel index (Modified Barthel index,MBI) were evaluated before and after treatment for 2 weeks, 6 weeks, 12 weeks later. Clothing and toilet) to assess the (Activities of daily living, ADL) ability of patients with daily life activities; The motor function of upper extremity was assessed by the simple Fugl-Meyer scale (Fugl-Meyer assessment scale,FMA) and the degree of muscle spasm was evaluated by modified Ashworth scale (Modified Ashworth scale,MAS). Results: after 2 weeks of treatment, the MAS scores of the patients in the treatment group were significantly different from those before treatment, and the scores of FMA and MBI were significantly higher than those of the control group. But there was no statistical significance compared with the control group. After 6 weeks and 12 weeks of treatment, the scores of MAS and MBI,FMA in the treatment group were significantly different from those before treatment, and the differences were statistically significant compared with those in the control group. It suggested that the activity of daily life and the function of limb movement in the treatment group were improved more obviously. In the control group, there was no significant difference in MAS score and MBI,FMA score between 2 weeks after treatment and before treatment. The difference was significant after 6 weeks and 12 weeks after treatment, indicating that routine treatment could improve the spasm state. The function of upper limb movement was improved and the ability of daily life was improved, but the remarkable effect was slow. It needed more than 6 weeks rehabilitation treatment to improve the motor function and daily living ability. Conclusion: Botulinum toxin injection can reduce muscle tension and improve spasticity. Combined with rehabilitation therapy, Botulinum toxin injection can obviously improve the ability of daily living and the function of limb movement. In the aspect of aging, the effect of spasmodic relief was obvious at the second week after injection, and stabilized at the sixth week, and the drug effect lasted until 12 weeks after treatment.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R743.3
本文編號：2337238
[Abstract]:Objective: to observe the effect of botulinum toxin A injection on the spasticity of upper extremities in stroke patients and to explore the relationship between muscle tension and the function of upper limb motility and activities of daily living. Methods: forty patients with stroke were randomly divided into two groups: the treatment group and the control group. The patients in the treatment group were given routine rehabilitation therapy after botulinum toxin A injection, while the patients in the control group were treated with conventional rehabilitation therapy only. Items related to upper limb movement (including eating, grooming, bathing) in the modified Barthel index (Modified Barthel index,MBI) were evaluated before and after treatment for 2 weeks, 6 weeks, 12 weeks later. Clothing and toilet) to assess the (Activities of daily living, ADL) ability of patients with daily life activities; The motor function of upper extremity was assessed by the simple Fugl-Meyer scale (Fugl-Meyer assessment scale,FMA) and the degree of muscle spasm was evaluated by modified Ashworth scale (Modified Ashworth scale,MAS). Results: after 2 weeks of treatment, the MAS scores of the patients in the treatment group were significantly different from those before treatment, and the scores of FMA and MBI were significantly higher than those of the control group. But there was no statistical significance compared with the control group. After 6 weeks and 12 weeks of treatment, the scores of MAS and MBI,FMA in the treatment group were significantly different from those before treatment, and the differences were statistically significant compared with those in the control group. It suggested that the activity of daily life and the function of limb movement in the treatment group were improved more obviously. In the control group, there was no significant difference in MAS score and MBI,FMA score between 2 weeks after treatment and before treatment. The difference was significant after 6 weeks and 12 weeks after treatment, indicating that routine treatment could improve the spasm state. The function of upper limb movement was improved and the ability of daily life was improved, but the remarkable effect was slow. It needed more than 6 weeks rehabilitation treatment to improve the motor function and daily living ability. Conclusion: Botulinum toxin injection can reduce muscle tension and improve spasticity. Combined with rehabilitation therapy, Botulinum toxin injection can obviously improve the ability of daily living and the function of limb movement. In the aspect of aging, the effect of spasmodic relief was obvious at the second week after injection, and stabilized at the sixth week, and the drug effect lasted until 12 weeks after treatment.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R743.3
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