摘要
目的观察胫神经运动支乙醇阻滞腓肠肌治疗老年脑卒中偏瘫后足下垂的临床结果。方法22例腓肠肌痉挛导致足下垂脑卒中偏瘫老年患者在电刺激引导定位下接受胫神经运动支无水酒精阻滞。采用踝跖屈改良Ashworth分级、踝阵挛分级以及被动踝关节活动度分别在注射前、注射后即刻、1 d、1周、1月以及3月进行肌痉挛严重程度评估。结果19例患者在3月随访期中改良Ashworth分级均明显下降,3例1周后进行重复注射。与注射前比较,注射后Ashworth分级(MAS)、踝阵挛分级(Clonus)、被动踝关节活动度(PROM)有显著性差异(P<0.01)。3月期间未发现严重的不良反应。结论胫神经运动支乙醇阻滞腓肠肌治疗脑卒中后偏瘫足下垂安全有效。
Objective To observe the clinical effects of alcohol neurolysis of tibial nerve motor branches to the gastrocnemius muscle on foot drop in patients with hemiplegic stroke. Methods Twenty-two patients with hemiplegie stroke showing foot drop due to gastrocnemius ankle plantarflexor spasticity accepted motor branch block （MBB） of the tibial nerve to the gastrocnemius muscle with 99. 9% ethyl alcohol. The severity of spasticity was assessed before and after MBB （0 h, 24 h,7 days, 1 month and 3 months） , using the Modified Ashworth Scale （MAS） score of ankle plantarflexor, clonus score of the ankle, and the passive range of motion （PROM） of ankle dorsiflexion. The Friedman test was used to compare the mean values before and after MBB. Results The MAS score was reduced in 19 patients during the 3-month follow- up, and spasticity reappeared at the level of the pre-MBB state in 3 patients who received repeated motor block. No serious complications were observed during the 3-month follow-up period. Conclusions MBB of the tibial nerve to the gastrocnemius muscle is effective and safe for relieving localized muscle spasticity of the ankle plantarflexors in patients with hemiplegic stroke.
出处
《实用老年医学》
CAS
2008年第6期447-448,480,共3页
Practical Geriatrics
关键词
脑卒中
乙醇阻滞
胫神经运动支
肌痉挛
stroke
alcohol neurolysis
tibial nerve motor branches
muscle spasticity
