摘要
目的 探讨痉挛性脑瘫的神经外科个性化手术治疗效果.方法 回顾分析2006年3月至2011年12月郑州大学第四附属医院治疗452例痉挛性脑瘫的临床资料.182例肢体多组肌群痉挛的患者行选择性颈、腰骶部后根神经切断术（SPR）,270例单一肌群痉挛的患者行选择性周围神经部分切断术（SPN）,116例合并肌腱挛缩和肢体畸形者同时行肌腱延长或切断及骨科矫形手术,46例合并流涎及徐动者同时行颈总动脉外膜剥脱术.结果 全部患者术后随访10~24个月,平均18个月.SPR手术肢体痉挛缓解率95.6%（348/364）,SPN手术肢体痉挛缓解率为98.3%（460/468）,颈总动脉外膜剥脱术后症状改善率91.3%（42/46）.SPR手术后肢体痉挛状态不同程度复发8例（4.4%）,SPN手术后肢体痉挛状态不同程度复发28例（10.4%）.结论 根据痉挛性脑瘫患者的临床表现采取个性化的手术治疗方案是手术成功的关键因素.
Objective To explore the outcomes of individualized neurosurgical treatments of spastic cerebral palsy. Methods A total of 452 spastic cerebral palsy patients undergoing microneurosurgery during March 2006 and December 2011 were retrospectively analyzed. Performed on the basis of clinical manifestations, comprehensive procedures included selective cutting of neck or lumbosaeral dorsal root ganglia （ SPR, n = 182 ） for multiple muscle spasm, selective peripheral neurotomy （ SPN, n = 270 ） for focal muscle spasm, line tendon lengthening or cutting and orthopedic surgery （n = 116） for tendon contracture plus limb deformities and carotid artery adventitia endarterectomy （n = 46 ） for salivation plus athetoid. Results The average follow-up period was 18 （ 10 - 24） months. The limb spasm relief rate of SPR was 95.6% and that of SPN 98.3%. And the postoperative symptom improvement rate of common carotid arterial adventitia stripping was 91.3%. There were g cases （4. 4% ） of recurrent spasticity after SPR and 28 （10. 4% ） after SPN. Conclusion Offering individualized microsurgical treatments on the basis of clinical manifestations is essential for patients with spastic cerebral palsy.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2014年第5期376-378,共3页
National Medical Journal of China
