王秋根 吴岳嵩 年申生 张春才 王家林 200433 上海， 第二军医大学长海 医院骨科 中华小儿外科杂志 1998 0 19 3


    关键词：脑性麻痹；选择性脊神经后根切断术 期刊 zhxrwkzz 0 临床研究 fur -->


    

摘要 目的：探讨轻度脑瘫的治疗方法及软组织手术适应证。方法：34例随机分两组，A组软组织手术组17例，行不同的软组织矫形术；B组SPR手术组17例，行神经后根不同比例的切除术。结果：SPR手术组术后，痉挛性症状全部消失，肌张力恢复正常，尖足行走及剪刀步消失，腱反射亢进术后1个月后消失，踝阵挛及病理反射亦全部消失。软组织手术组，痉挛性症状术后不能消失。肌张力不变，尖足行走消失，腱反射仍亢进。功能评价：所有患儿术前均不能单腿站立或站立不稳，在SPR手术组的17例中，术后半年能较稳定的单腿站立者10例，占58.8%，而软组织手术组17例中，术后半年能较稳定的单腿站立只有8例，占47.1%，两组患儿术后均能较稳定的在宽广场地上行走，但SPR组术后对躯干的控制能力较软组织手术组好。表现为行走稳定，左、右转动自如。结论：两者均能较明显的改善行走的步态，但各自不同。

    Selective PosteriorRhizotomy and Soft Tissue Operation on Spastic Ce rebral Palsy

Wang Qiugen, Wu Yuesong, Nian Shensheng, et al. Department of Orth opaedics,

    Shanghai Changhai Hospital, Shanghai 200433

Abstract Objective: To compare the results of selectiveposterior rhizotomy(SPR)and soft tissue operation on children with spastic cerebral palsy.Methods: Thirty-four children with cerebral palsy were randomized into two groups:A) 17patients underwent soft tissue corrective surgery and B) 17 patients underwent SPR.Results: In group A there was residual spasm. Musculart ension remained unchanged andtiptoeing disappeared. Hyperreflexia persisted. In group B spasm was eliminated. Musculartension returned to normal. Tiptoeing an dscissors gait disappeared. Hyperreflexiadiminished one month post-operatively. Both groups showed improvement in gait. Morepatients from group A than group B could stand steadily on one foot six monthspost-operatively(10 vs 8). Group B patients had better control of trunk than group Aevidenced by steadier gait and easier turning of the body. Conclusion: Both soft tissueoperation and SPR improved the gait of children with cerebral palsy, although the benefitof each operation may differ.

     ......