高年进 郑春艳

[摘要]目的分析痙挛型脑瘫患儿肌内注射 A 型肉毒毒素（BTX-A）联合优质护理干预的效果。方法本研究选取广东三九脑科医院2018年7月至2020年6月收治的痉挛型脑瘫患儿30例进行研究，按照简单随机的原则将其分为观察组和对照组，每组各15例，均行肌内注射 BTX-A 治疗，观察组采用优质护理干预，对照组采用常规护理干预。比较两组患儿肌张力改善情况、改良巴氏指数量表评分及不良反应发生情况。结果干预后，观察组运动肌群肌张力评定表评分低于对照组，差异有统计学意义（ P <0.05）;干预后，观察组改良巴氏指数量表评分明显高于对照组，差异有统计学意义（ P <0.05）。两组不良反应总发生率比较，差异无统计学意义（ P >0.05）。结论对痉挛型脑瘫患儿进行肌肉注射 BTX-A 治疗联合优质护理干预，可有效改善患儿肌张力情况，恢复患儿肌肉功能，提高患儿运动能力，同时未增加不良反应总发生率。

[关键词]痉挛型脑瘫;患儿;A 型肉毒毒素;护理

[中图分类号] R742.3 [文献标识码] A  [文章编号]2095-0616（2021）22-0101-04

Effect of intramuscular injection of botulinum toxin A combined with high-quality nursing on children with spastic cerebral palsy

GAO  Nianjin   ZHENG  Chunyan

Cerebral Palsy Treatment Center， Guangdong 999 Brain Hospital， Guangdong， Guangzhou 510510， China

[Abstract] Objective To analyze the effect of high-quality nursing characteristics in children with spastic cerebral palsy （SCP） after intramuscular injection of botulinum toxin type A （BTX-A）. Methods This study selected 30 SCP children from July 2018 to June 2020 in Guangdong 999 Brain Hospital， and divided them into the observation group and the control group according to the principle of simple and random， with 15 cases in each group， all of whom were treated with BTX-A injection. The observation group received high-quality nursing intervention and the control group received conventional nursing intervention. The improvement the scores of the exercise muscles， the score of the modified Babbitt index and the occurrence of adverse reactions were compared between the two groups. Results After the intervention， the scores of the exercise muscles in the observation group were lower than those in the control group， with the difference was statistically significant （P <0.05）. After the intervention， the score of the modified Babbitt index of the observation group was significantly higher than that in the control group， with the difference was statistically significant （P <0.05）. There was no statistically significant difference in the total incidence of adverse reactions between the two groups （P >0.05）. Conclusion Intramuscular injection of BTX-A treatment for SCP children combined with high-quality nursing intervention can effectively improve the muscle strength， restore the muscle function， and improve the exercise ability without increasing the total occurrence of adverse reactions.

[Key words] Spastic cerebral palsy; Pediatric patients; Botulinum toxin type A; Nurse

脑性瘫痪是兒科较为常见的运动功能异常且发生病态改变的中枢神经系统发育疾病[1]，该病多发生于出生后1个月内，由多种原因导致，临床表现主要为智力低下、语言功能及行为功能异常，并伴有感知觉障碍、癫痫等症状[2]，可引起小儿残疾。研究表明，A 型肉毒毒素（BTX-A）是一种松弛肌肉、改善肌肉痉挛的药物，具有安全性高、疗效确切的优点[3]。患儿需在有效治疗后接受规范的康复治疗及中医理疗，并结合不同形式的护理以增加康复效果，减少畸形发生[4]。本研究选取我院2018年7月至2020年6月收治的痉挛型脑瘫患儿30例进行研究，分析 BTX-A 治疗联合合优质护理干预的效果，现报道如下。……