中国中西医结合儿科学2025，Vol.17Issue(4)：313-319,7.DOI:10.20274/j.cnki.issn.2025.04.007
超声引导下A型肉毒毒素注射治疗脑性瘫痪下肢痉挛的疗效和随访研究
Efficacy and follow-up of ultrasound-guided botulinum toxin type A injection for lower limb spasticity in cerebral palsy
摘要
Abstract
Objective To investigate the clinical efficacy of ultrasound-guided botulinum toxin type A(BTX-A)injection combined with conventional rehabilitation training in the treatment of lower limb spasticity in children with cerebral palsy(CP).Methods A total of 69 children with spastic CP who were admitted to Harbin Children′s Hospital(The Sixth Affiliated Hospital of HMU)and Longgang District Maternal and Child Health Hospital of Shenzhen between June 2017 and March 2022 were randomized into a control group(n=35)and an observation group(n=34).All participants received a standardized rehabilitation protocol:(1)basic motor function reconstruction(task-oriented training,30 min/session);(2)soft tissue management(wax therapy at 52-55℃,30 min/session);(3)neuromuscular modulation(low-frequency electrical stimulation at 1 Hz,pulse width 100 ms).The observation group additionally received precise positioning injection:ultrasound-guided BTX-A injection(dilution:50 IU/mL)was performed at gastrocnemius(4-6 IU/kg),and at soleus,semitendinosus and semimembranosus(1-2 IU/kg)based on disease condition.The systematic treatment lasted for 6 months as a course,and the injection was completed at 0 month after the first assessment.Outcomes were assessed by double-blinded assessment team during the follow-ups at baseline,and after 1,6,and 12 months of treatment through:(1)dynamic assessment of muscular tension using modified Tardieu scale(MTS)to measure the range of motion at 0°and V3 velocity;(2)progress in motor function using gross motor function measurement(GMFM)to score the dimensions D/E;(3)life participation using functional independence measurement for children(WeeFIM)to make quantitative analysis.Results Both groups showed progressive decrease in MTS scores and gross motor function classification system(GMFCS)levels(P<0.05),and progressive increase in GMFM and WeeFIM scores(P<0.05)after 1,6,and 12 months of treatment.The observation group demonstrated significantly lower MTS scores(P<0.05)and significantly higher GMFM/WeeFIM scores(P<0.05)than the control group at all post-treatment intervals.Conclusions Ultrasound-guided BTX-A injection is feasible for alleviating lower limb spasticity in children with spastic CP,which effectively improves muscle function,gross motor function,and functional independence,so this combined therapy is worthy of clinical promotion and application.关键词
脑性瘫痪/痉挛/A型肉毒毒素/粗大运动功能/儿童Key words
Cerebral palsy/Spasticity/Botulinum toxin type A/Gross motor function/Child分类
医药卫生引用本文复制引用
钟增泉,姜雪,孙双全,李翌鸣,李威,张欣,历虹,吕智海..超声引导下A型肉毒毒素注射治疗脑性瘫痪下肢痉挛的疗效和随访研究[J].中国中西医结合儿科学,2025,17(4):313-319,7.基金项目
2022年度黑龙江省卫生健康委科技计划项目(20222020011008,20222020010975) （20222020011008,20222020010975）
深圳市龙岗区医疗卫生科技计划项目(LGWJ2021-68) （LGWJ2021-68）
深圳市龙岗区医学重点学科建设项目 The Science and Technology Program of Heilongjiang Provincial Health Commission(No.20222020011008,20222020010975) （No.20222020011008,20222020010975）
