摘要
目的观察肌电/电刺激和超声两种引导方式下注射肉毒毒素对脑卒中屈腕和屈指痉挛患者痉挛和运动功能的影响。方法回顾2015年1月至2019年5月脑卒中后屈腕及屈指痉挛并注射A型肉毒毒素治疗的患者,根据引导方式分为肌电/电刺激引导组(n=36)和超声引导组(n=37),治疗前后采用改良Ashworth量表(MAS)和FuglMeyer评定量表(FMA)中腕和手指部分进行评定。结果治疗4周后,两组MAS和FMA评分均显著改善(|Z|> 4.654, P <0.001);超声引导组MAS评分优于肌电/电刺激引导组(|Z|> 1.980, P <0.05);超声引导组药物用量显著低于肌电/电刺激引导组(t=4.023, P <0.001)。结论超声引导下注射肉毒毒素改善脑卒中后腕指屈肌痉挛优于肌电/电刺激引导。
Objective To compare the effects of Botulinum toxin type A(BTX-A) injection guided with electromyographic/electric stimulation or ultrasonography in patients with post-stroke spasticity of wrist and finger flexor muscles.Methods Inpatients with post-stroke spasticity of wrist and finger flexor muscles accepted BTX-A injection from January, 2015 to May, 2019 were reviewed. They were divided into electromyographic/electric stimulation-guided group(n = 36) and ultrasound-guided group(n = 37). They were assessed with modified Ashworth Scale(MAS)and Fugl-Meyer Assessment(FMA) before injection and four weeks after treatment.Results The scores of both MAS and FMA improved in both groups after treatment(|Z| > 4.654, P < 0.001), and the scores of MAS improved more in the ultrasound-guided group(|Z| > 1.980, P < 0.05), with less dosage of BTX-A(t = 4.023, P < 0.001).Conclusion Ultrasound-guided injection of BTX-A is more effective on wrist and finger flexion muscles spasticity than electromyographic/electric stimulation-guided method in stroke patients.
作者
芦海涛
崔利华
王艺铮
LU Hai-tao;CUI Li-hua;WANG Yi-zheng(Neurorehabilitation Center,Beijing Bo'ai Hospital,China Rehabilitation Research Center,Beijing 100068,China;Capital Medical University School of Rehabilitation Medicine,Beijing 100068,China;Physical Medicine&Rehabilitation Development,Beijing Fengtai You'anmen Hospital,Beijing 100054,China)
出处
《中国康复理论与实践》
CSCD
北大核心
2019年第11期1352-1355,共4页
Chinese Journal of Rehabilitation Theory and Practice
关键词
脑卒中
痉挛
超声
肌电图
电刺激
肉毒毒素
stroke
spasticity
ultrasonography
electromyography
electric stimulation
Botulinum toxin
