摘要
目的 分析脑瘫患儿的自身情况包括年龄、性别、体重、受累肢体数量及粗大运动功能得分与选择性脊神经后根切断术（SPR）后患儿运动功能康复效果的相关性,探索可能影响SPR后痉挛型脑瘫患儿运动功能康复效果的因素.方法 本研究于2013年10月—2015年10月纳入在北京中医药大学东直门医院骨科和康复科就诊的痉挛型脑瘫患儿53例.在SPR术后均接受统一标准的康复治疗,并分别在手术前和康复治疗半年后应用粗大运动功能量表（GMFM）进行运动功能评价,然后分析患儿年龄、性别、体重、治疗前GMFM得分及患儿受累肢体数量与治疗前后运动功能评价结果差值的相关性.结果 患儿术后半年运动功能提高分值与其年龄呈负相关性（r=-0.30,P〈0.01）,与性别无相关性（r=0.00,P=1.00）,与患儿体重呈负相关性（r=-0.30,P〈0.01）,与治疗前运动功能水平无相关性（r=-0.20,P〉0.05）,与患儿受累肢体数量无相关性（r=-0.20,P〉0.05）.结论 年龄3~25岁的痉挛型脑瘫患儿进行SPR术治疗显示年龄越小,治疗效果越明显;患儿应适当控制体重,以免影响患儿手术后康复疗效;不能应用患儿性别、治疗前运动功能水平及受累肢体数量来预测患儿术后运动功能恢复情况;研究者将进一步开展大样本及多因素研究,以验证当前结论及更全面进行SPR术疗效影响因素分析.
Objective To analyze the correlation between the condition of patients with spastic cerebral palsy, including age, sex, weight, number of the affected limb and gross motor function and their rehabilitation effect after selective posterior rhizotomy （SPR）, and to explore the possible factors that contribute to the rehabilitation of motor function in patients with spastic cerebral palsy.Methods Totally 53 patients with spastic cerebral palsy admitted in the Departments of Orthopedics and Rehabilitation of Dongzhimen Hospital, Beijing University of Chinese Medicine were selected from October 2013 to October 2015. The patients received uniform and standard rehabilitation treatment after SPR, and their motor function was evaluated with the Gross Motor Function Measure （GMFM） before the surgery and six months after the surgery. Then the correlation between the patients＆#39; age, sex, weight, GMFM score before treatment and number of the affected limb and the difference in their motor function before and after treatment was analyzed.Results The patients＆#39; score in improved motor function was negatively correlated with their age （r=-0.30,P〈0.01） and weight （r=-0.30, P〈0.01）, and not correlated with their sex （r=0.00,P=1.00）, motor function before treatment （r=-0.20,P〉0.05） or number of the affected limb （r=-0.20,P〉0.05）.Conclusions For patients aged between 3 and 25, the earlier they are treated, the better the effect is. The patients should control their weight properly so as not to affect the rehabilitation effect after surgery. The patients＆#39; sex, motor function before treatment and number of the affected limb cannot help to predict the recovery of their motor function after surgery. Researchers will continue to conduct large-sample and multi-factor studies in order to verify the current conclusions and analyze the influencing factors of SPR effect in a more comprehensive way.
出处
《中华现代护理杂志》
2017年第29期3745-3748,共4页
Chinese Journal of Modern Nursing
基金
2015年北京中医药大学校级自主课题（2015-JYB-JsMs068）
北京中医药大学东直门医院2016青苗人才培养计划
关键词
痉挛型脑瘫
选择性脊神经后根切断术
术后运动功能
相关因素
Spastic cerebral palsy
Selective posterior rhizotomy
Postoperative motor function
Relevant factors
