A 型肉毒毒素对脑出血后下肢肌痉挛患者的影响

Effect of botulinum toxin type A on lower limb spasticity in patients with cerebral hemorrhage

摘要:

目的 探讨A 型肉毒毒素在脑出血后下肢肌痉挛患者中的效果。方法 选取2014 年3 月-2015 年8 月于郑州大学附属医院南阳医院收治的脑出血后下肢痉挛患者104 例，依据随机数表法分为观察组（A 型肉毒毒素）和对照组（酒精），比较两组患者的下肢功能、步行速度及关节活动度等相关指标。结果 观察 组治疗后MAS 评分低于对照组，FMA、BBS 评分高于对照组（P <0.05）。观察组治疗后的10 m 步行时间和 3 m 起- 坐时间低于对照组，步速高于对照组（P <0.05）。观察组治疗后肌表面肌电积分值低于对照组，被动 关节活动度高于对照组（P <0.05）。结论 局部注射A 型肉毒毒素治疗脑出血后下肢肌痉挛患者成效显著， 能够解除下肢肌痉挛，明显改善患者的下肢运动功能，增加关节活动度，值得临床推广。

Abstract:

Objective To investigate the effect of botulinum toxin type A in the patients with lower limb muscle spasm after cerebral hemorrhage. Methods One hundred and four patients with lower limb muscle spasm after cerebral hemorrhage admitted to our hospital from March 2014 to August 2015 were selected. According to the random number table method, the patients were divided into the observation group (botulinum toxin type A) and the control group (alcohol). The lower extremity function, walking speed, joint mobility and other related indicators were compared between the two groups. Results Before treatment, there was no significant difference in MAS, FMA or BBS score between the two groups (P > 0.05). After treatment, the MAS score of the observation group was significantly lower than that of the control group, while FMA and BBS scores were significantly higher than those of the control group (P < 0.05). Before treatment, there was no significant difference in walking speed, 10-meter walking time or 3-meter up-sitting time between the two groups (P > 0.05). After treatment, the 10-meter walking time and 3-meter up-sitting time of the observation group were significantly shorter than those of the control group, while the walking speed was faster than that of the control group (P < 0.05). Before treatment, there was no significant difference in muscle surface electromyographic score or passive range of motion between the two groups (P > 0.05). After treatment, the muscle surface electromyographic score of the observation group was significantly lower than that of the control group, the passive range of motion was significantly higher than the control group (P < 0.05). Conclusions Local injection of botulinum toxin type A has remarkable effect in the treatment of lower limb spasticity in the patients with cerebral hemorrhage. It can relieve muscle spasm of the lower limbs, significantly improve lower limb motor function, and increase joint mobility in the patients, and is worthy of promotion.