关节腔注射A型肉毒毒素治疗卒中后肩痛的疗效观察

发布时间：2018-03-28 17:43

本文选题：卒中后肩痛　切入点：A型肉毒毒素　出处：《中国康复医学杂志》2017年01期

【摘要】：目的:比较关节腔注射A型肉毒毒素(botulinum toxin type A,BTA)与类固醇治疗卒中后肩痛的疗效。方法:46例卒中后肩痛患者随机分为治疗组和对照组,超声引导下行关节腔注射,治疗组注射A型肉毒毒素和利多卡因,对照组注射曲安耐德和利多卡因。治疗前、治疗后即刻、1周后、4周后对患者进行评定。内容包括视觉模拟评分(VAS);Fugl-Meyer简式运动功能评定上肢部分;肩关节屈、外展、外旋被动关节活动度(ROM)。结果:治疗后即刻和1周后,两组VAS降低,与治疗前差异均有显著性意义(P0.05);4周后治疗组仍有差异(P0.05),对照组与治疗前无差异。两组的Fugl-Meyer简式运动功能评定在治疗后即刻和1周后均无改善,4周后两组评分均提高,与治疗前差异有显著性意义(P0.05)。治疗后即刻,两组外旋ROM改善,与治疗前差异均有显著性意义(P0.05),治疗组4周后仍有差异(P0.05),对照组1周后和治疗前差异无显著性意义。治疗1周后,对照组屈曲ROM改善,与治疗前差异有显著性意义(P0.05);4周后治疗组屈曲ROM改善,与治疗前差异有显著性意义(P0.05),对照组与治疗前无差异。两组外展ROM较治疗前无明显改善。结论:关节腔注射BTA能减轻卒中后肩痛的疼痛程度,并改善肩关节ROM,疗效可能优于曲安耐德。
[Abstract]:Objective: to compare the therapeutic effects of botulinum toxin type (BTAA) and steroids on shoulder pain after stroke. Methods: 46 patients with shoulder pain after stroke were randomly divided into treatment group and control group. Before treatment, the treatment group was injected with botulinum toxin A and lidocaine, while the control group was injected with triamide and lidocaine. The patients were evaluated immediately after 1 week of treatment and 4 weeks later. The contents included visual analogue score and Fugl-Meyer simple motor function assessment of upper limb, shoulder flexion, abduction, and lateral passive motion. Results: immediately after treatment and 1 week after treatment, VAS decreased in both groups. There were significant differences between the two groups after 4 weeks of treatment, but there was no difference between the control group and the control group. The Fugl-Meyer motor function assessment of the two groups was not improved immediately after treatment and 1 week after treatment. There was a significant difference between the two groups before and after treatment (P 0.05). Immediately after treatment, the external rotation ROM of the two groups was improved, and there was a significant difference between the two groups before and after treatment. There was still a significant difference in the treatment group after 4 weeks, but there was no significant difference between the control group and the control group after 1 week and before treatment, after 1 week of treatment, there was no significant difference between the treatment group and the control group, after 1 week of treatment, there was no significant difference between the two groups. The ROM of flexion in the control group was improved significantly compared with that before treatment, and the ROM was improved in the treatment group after 4 weeks of treatment. There was significant difference between the two groups before treatment and before treatment, but there was no difference between the control group and the control group before treatment. There was no significant improvement in abduction ROM between the two groups. Conclusion: the degree of shoulder pain after stroke can be alleviated by intraarticular injection of BTA. And improve the shoulder rom, the effect may be better than Trianide.
【作者单位】：青岛大学附属医院康复医学科;
【基金】：青岛市民生科技计划(13-1-3-34-nsh)
【分类号】：R743.3;R493

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