梁秋叶+覃花桃+凌赛泳+黄境旺

【摘要】目的探讨痉挛肌治疗仪结合家庭康复在痉挛型脑瘫儿童康复中的疗效，为降低患儿致残率提供参考。

方法选择2015年1～ 10月在儿童保健康复科治疗的118例痉挛型脑瘫患儿，进行临床随机对照研究，分观察组和对照组各59例，对照组采用药物治疗+运动疗法+引導式教育，观察组在对照组治疗基础上同时采用痉挛肌治疗仪治疗结合家庭康复。采用改良Ashworth量表法（MAS）、GMFM88项粗大运动功能评定表和Peabody精细运动发育量表在治疗9个月后进行评估，比较两组各项指标情况。

结果观察组在治疗9个月后肌张力的等级评分总有效率为61.0%，比对照组33.9%明显提高，治疗后两组GMFM各功能区得分均较治疗前明显提高，观察组各项指标均显著优于对照组（P<0.001），治疗后两组精细运动发育商及抓握指数评分、视觉-运动整合指数粗分均较治疗前明显提高，观察组各项指标均显著优于对照组（P<0.001）。

结论以综合康复治疗为基础的痉挛肌治疗仪结合家庭康复治疗痉挛型脑瘫儿童，临床疗效更快、更明显，预后更好，降低了致残率，减轻家庭和社会的负担，值得临床推广应用。

【关键词】痉挛肌治疗仪；痉挛型脑瘫；家庭康复

中图分类号：R748文献标识码：ADOI：10.3969/j.issn.10031383.2017.02.009

【Abstract】ObjectiveTo investigate the curative effect of spastic muscle therapeutic apparatus combined with family rehabilitation therapy for children with spastic cerebral palsy，so as to provide reference for decreasing their disability rate.

MethodsClinical randomized comparison study was carried out to 118 children with spastic cerebral palsy treated in our children health department from January to October，2015.They were divided into observation group and control group，with 59 cases in each group.The control group were given drug and sports therapy as well as conductive education，and based on which the other group were given spastic muscle therapeutic apparatus combined with family rehabilitation therapy.After 9 months of treatment，modified Ashworth scaling （MAS），GMFM （gross motor function measure scale 88） and Peabody developmental motor scale were adopted to evaluate the relative indexes of the two groups.

ResultsAfter 9 months of treatment，the total effective rate of grading of muscle tension in the observation group was 61.0%，significantly higher than that（33.9%） of the control group.Both group got higher scores in each GMFM functional area after treatment，while the observation group held better indexes than the control group（P<0.001）.Moreover，the two groups got higher scores in fine motor quotient（FMQ），grasp index and visualmotion index after treatment，and the observation group held better indexes than control group（P<0.001）.

ConclusionBased on comprehensive rehabilitation therapy，spastic muscle therapeutic apparatus combined with family rehabilitation have better clinical effect and more favorable prognosis，which can decrease disability rate and lighten burden on family and society.Thus it is worth clinical application.

【Key words】spastic muscle therapeutic apparatus；spastic cerebral；family rehabilitation therapy

痉挛型脑瘫主要表现为肌张力增高，关节活动度减小，运动障碍。治疗原则是降低肌张力，维持扩大关节活动度，预防关节畸形挛缩，降低致残率。目前为止对痉挛型脑瘫患儿尚无特效治疗药物，但早期实施干预措施可明显提高患者生活质量。……