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痉挛型脑瘫手术加康复分段梯度治疗的临床研究
引用本文:常崇旺,王学廉.痉挛型脑瘫手术加康复分段梯度治疗的临床研究[J].生物磁学,2011(19):3687-3690.
作者姓名:常崇旺  王学廉
作者单位:第四军医大学唐都医院神经外科,陕西西安710038
摘    要:目的:探索选择性脊神经后根切断术(selective posterior rhizotomy,SPR)、外周神经缩窄术、下肢矫形术加康复个性化的组合方式对痉孪性脑瘫的疗效,寻找最佳的综合治疗方案。方法:对2007.2到2008.11期间32例痉挛性脑瘫患者,男24例,女8例。平均年龄7.1岁,完成手术加康复的分段梯度疗法,采用自身前后对照研究。进行治疗前、治疗后脑瘫分项功能评分和脑瘫痉挛临床分项评估以及肌力评价及总体疗效评估。结果:梯度疗法治疗后,脑瘫分项中坐姿、躯干活动、蹲立变换分别是94%、91%和91%,均有显著性意义;踝阵孪和Babinski征改善率分别为97.2%和54%。脑瘫分项功能的评分的恢复率均在80%以上。全组疗效优18例(56.3%),良12例(37.5%),可2例(6.2%),优良率93.8%。结论:分度梯度疗法是治疗各种痉挛性脑瘫的有效途径。

关 键 词:痉挛性脑瘫  手术治疗  分段梯度疗法  康复

Surgery and Rehabilitation Piecewise Gradient Therapy for Spastic Cerebral Palsy
CHANG Chong-wang,WANG Xue-lian.Surgery and Rehabilitation Piecewise Gradient Therapy for Spastic Cerebral Palsy[J].Biomagnetism,2011(19):3687-3690.
Authors:CHANG Chong-wang  WANG Xue-lian
Affiliation:(Department ofNeurosurgety, Tangdu Hospital, Fourth Military Medical University, Xi'an 710038)
Abstract:Objective: To seek the best collaboration of the various Personalized combination of the selective posterior rhizotomy (SPR), the peripheral nervous constrictive operation, the lower limbs orthopaedic operation and the rehabilitation training to the spastic cerebral palsy (SCP). Methods: We gained 32 patients of SCP from Feb. 2007 to Nov. 2008. Among them there were 24 male and 8 female, mean of age was 7.1. All the patients accepted the piecewise gradient therapy of operation and rehabilitation. This study adopted before and after treatment control method. The study observed the cerebral palsy partial functional score, the cerebral palsy spasms clinical sub-item evaluation, the muscle evaluation and the overall efficacy. Results: Compared to preoperation, among the cerebral palsy breakdown the sitting posture, the torso activities and the squat made transformation of the postoperation patients had improved significantly and the rates of the improvvmvnt were 94%, 91% and 91% accordingly. And the improvement rates of article clonus and the Babinski were 97.2% and 54%. The recovery rate of the cerebral palsy sub-item function was above 80%. The curative effect of the whole group were excellent 18 cases (56.3%), fine 12 cases (37,5%), can 2 cases (6.2%). Conclusion: The piecewise gradient therapy is the effective shortcut of the various kinds of spastic cerebral palsy,
Keywords:The spastic cerebral palsy  Surgery  The piecewise gradient therapy  Recovery
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