周围神经缩窄术结合康复训练对痉挛型脑性瘫痪患儿运动功能的影响

被引：12

作者：

袁俊英 ^{[1
]}

董辉 ^{[2
]}

曾宪旭 ^{[1
]}

孙二亮 ^{[1
]}

王军 ^{[1
]}

机构：

[1] 郑州大学第三附属医院脑瘫康复中心

[2] 郑州大学第三附属医院神经外科

来源：

中华实用儿科临床杂志 | 2014年 / 29卷 / 20期

关键词：

脑性瘫痪; 周围神经缩窄术; 粗大运动功能评估; Berg平衡量表;

D O I：

暂无

中图分类号：

R742.3 [大脑性瘫痪]; R493 [医学康复（康复疗法）];

学科分类号：

100204 [神经病学]; 100232 [康复医学];

摘要：

目的探讨周围神经缩窄术结合康复训练对痉挛型脑性瘫痪(脑瘫)患儿粗大运动功能和平衡功能的影响。方法选取2011年5月至2013年10月30例住院的年龄>3岁且意识清楚需行周围神经缩窄术并结合康复训练的痉挛型脑瘫患儿为研究组;采用配对设计的方法选择同期住院30例年龄相近、性别相同, 粗大运动功能分级(GMFCS)相同, 功能相近行单纯综合康复训练的脑瘫患儿作为对照组。分别在训练开始后2周、4周、6周、8周、10周时记录2组患儿的改良Ashworth评分、粗大运动功能量表D、E区评分、医师等级评价量表评分结果, 采用重复测量分差分析方法比较2组患儿改良Ashworth肌张力、粗大运动功能、平衡功能以及步态改善情况。结果肌张力降低效果方面, 研究组与对照组比较差异有统计学意义(F=8.177, P=0.006);在步态改善方面, 研究组优于对照组(F=24.284, P=0.000);粗大运动功能量表D、E区评价中, 研究组与对照组相比差异均无统计学意义(D:F=0.072, P=0.790;E:F=0.000, P=0.985);在平衡功能Berg量表评分方面, 研究组与对照组相比差异亦无统计学意义(F=0.150, P=0.700)。结论周围神经缩窄术结合康复训练与单纯综合康复训练均可以提高痉挛型脑瘫患儿粗大运动功能和平衡功能, 但在降低肌张力与改善步态方面周围神经缩窄术组明显好于单纯康复训练。

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