【摘要】 为探讨选择性脊神经后根切断术及康复治疗对痉挛性脑瘫患者的姿势及行走能力的影响 ,将 34例痉挛性脑瘫患者分为 2组。治疗组选择性切断脊神经后根术后 3～ 5 d开始康复训练 ,训练方法以 Bobath法为基础 ,加上作业治疗。对照组术后仅对家长予以康复指导。结果 :2组坐位、直跪、站立及行走 4种姿势均有改善。治疗组术前与康复治疗后行走潜能评分差异有显著性 (t=4.5 9,P<0 .0 0 1) ;康复治疗后治疗组与对照组比较行走潜能评分差异亦有显著性 (t=2 .93,P<0 .0 1)。提示 :SPR术解除痉挛 ,但病理运动模式仍存在 ,肌无力亦不能解决 ,但康复训练可促进躯干肌及下肢肌的肌力增强 ,逐渐建立良好的调正和平衡反应 ,抑制异常运动模式 ,提高姿势的控制能力并显著提高患儿行走能力更多还原

【Abstract】 To explore the effect of selective posterior rhizotomy (SPR) and rehabilitation therapy on posture control and walking ability of the patients with spastic cerebral palsy, rehabilitation was arranged 3 to 5 days after SPR operation. Occupational therapy was used to assist Bobath method which formed the base of PT. Results showed that sitting, kneeling and standing posture were obviously improved after operation and rehabilitation. Walking potential ability scores were significantly different between pre operation and post rehabilitation ( P <0 001). SPR operation could gently decreased muscle tone and relieved spasticities, but abnormal movement pattern still existed, while rehabilitation therapy stressed enhancing muscle strength, restraining abnormal movement pattern, promoting balance and righting reaction and ability of posture control.更多还原