【摘要】 目的:探讨A型肉毒毒素局部注射治疗脑卒中后上肢屈肌痉挛的疗效。方法:选择12例脑卒中后遗症期的患者,均有偏瘫侧上肢屈肌张力明显增高,改良的Ashworth量表评分Ⅱ～Ⅲ级,肘关节活动范围受限,影响患者日常生活能力。根据患者的具体情况,使用不同剂量的肉毒毒素(100～150单位)稀释后分6～8点患侧肱二头肌局部注射,在注射后2,4,12周时,分别进行痉挛和关节活动范围的再评估,进行比较。结果:A型肉毒毒素局部注射治疗后2,4,12周患者肱二头肌痉挛程度分别为1.7±0.6,1.4±0.4,1.6±0.5均较注射前2.6±0.8显著改善(P<0.05)。患者的关节主动、被动活动范围在注射2,4,12周后较注射前亦有显著增加,分别为(124.2±14.6)°,(126.8±10.5)°,(123.8±7.6)°和(108.6±12.1)°,(107.4±13.2)°,(103.2±8.6)°(P<0.05)。结论:A型肉毒毒素局部注射治疗脑卒中后上肢屈肌痉挛具有较好的疗效。更多还原

【Abstract】 AIM:To explore the effect of local injection of botulismotoxin A on spasticity of the upper limb flexor after stroke. METHODS:Twelve patients with hemiplegia after stroke were selected.All patients had apparent increase of upper limb flexor muscular tension,modified Ashworth scale ranged 2-3 degree and limit of elbow joint range of motion,which influenced the ability of daily life.Different doses of botulismotoxin A(100-150 units) were injected to the biceps brachii muscle of the patients on 6-8 points after dilution according to the their conditions.The degree of spasticity and range of elbow joint motion were evaluated at the 2nd,4th,12th weeks after injection,compared with those of preinjection. RESULTS:The degree of spasticity of biceps brachii muscle at the 2nd,4th,12th weeks after injection(1.7±0.6,1.4±0.4,1.6±0.5) were significantly improved compared with that of preinjection(2.6±0.8)(P< 0.05).The active[(124.2±14.6)°,(126.8±10.5)°,(123.8±7.6)°and passive[108.6±12.1)°,(107.4±13.2)°,(103.2±8.6)°] range of elbow joint motion after 2th,4th,12th weeks were also significantly increased(P< 0.05). CONCLUSION:Local injection of botulismotoxin A has a better effect on spasticity of the upper limb flexor after stroke.更多还原