目的 探讨选择性上肢肌皮神经、正中神经部分切断术治疗肘腕痉挛型脑瘫患儿的临床效果.方法 收集33例肘腕痉挛型的脑瘫患儿均为2013年3月至2015年3月在该院接受选择性上肢肌皮神经、正中神经部分切断术,对其术前、术后神经功能评估及生活质量作回顾性分析.结果 患儿经手术治疗后肌张力显著降低,痉挛程度明显减轻,主动活动度较大改善,未出现明显的术后并发症.随访1年显示患儿生活质量明显改善,随访6个月和随访1年综合痉挛量表(CSS)评分明显高于术前,差异有统计学意义(P<0.05),随访1年肘关节改善(50~700)与随访6个月时的改善率比较,差异有统计学意义(P<0.05).结论 采用选择性上肢肌皮神经、正中神经部分切断术对肘腕痉挛型脑瘫患儿进行治疗,能有效缓解肘腕痉挛状态,减小残障程度,提高患儿的生活质量.%Objective To investigate the selective upper limb nerve,median nerve partial amputation of w rist and elbow clinical effect in children with spastic cerebral palsy.Methods Elbow,w rist spastic cerebral palsy 33 cases of clinical data,from March 2013 to March 2015 in our hospital undergoing elective upper limb nerve,median nerve partial amputation treatment,its preoperative,nerve functional assessment and quality of life after the retrospective analysis.Results After surgery,the treatment of muscle tension decreased effec-tively,significantly reduced the degree of spasticity,active activity improved significantly,w hile no significant complications.1 years of follow-up significantly improved the quality of life after surgery,the follow-up of 6 months and 1 year follow-up CSS score significantly higher than the preoperative CSS score,the difference was statistically significant(P<0.05),elbow(50―700)to improve the rate of the difference was statistically significant and were followed up for 6 months to improve the elbow joint(P<0.05).Conclusion The selec-tive upper limb nerve,median nerve partial amputation of the elbow to the w rist with spastic cerebral palsy treatment,the feasibility of high,can effectively relieve spasticity,elbow,w rist,reducing the degree of disabili-ty,to improve the lives of children quality plays an important role.
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