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鞘内注射巴氯芬对脑瘫患儿肌张力障碍的影响及功能量表的应用

Effect of intrathecal baclofen on dystonia in children with cerebral palsy and the use of functional scales.

作者信息

Motta Francesco, Stignani Cecilia, Antonello Clara Eleonora

机构信息

Department of Pediatric Orthopedics, V. Buzzi Children's Hospital, Via Castelvetro 32, Milan, Italy.

出版信息

J Pediatr Orthop. 2008 Mar;28(2):213-7. doi: 10.1097/BPO.0b013e3181653b2a.

Abstract

BACKGROUND

The literature available shows that spasticity in patients with cerebral palsy (CP) is reduced by intrathecal baclofen (ITB) treatment, and various studies suggest that this treatment can also be used in dystonic patients. The aim of the present study was to evaluate dystonia treated with ITB in children with CP.

METHODS

Data of 19 patients affected by dystonia as an outcome of infant CP in patients belonging to level V of Gross Motor Function Classification System treated with ITB were collected. The mean age at implant is 8.49 years.The patients are assessed using Barry-Albright Scale and Burke-Fahn-Marsden Scale before treatment and at 3, 6, and 12 months postimplant.

RESULTS

The results showed a statistically significant improvement (P < 0.001) in the total scores of the 2 scales after just 3 months of treatment, an improvement that was maintained for the 1-year period of follow-up. The results also revealed a reduction in dystonias, an improvement in posture, and an easing of the task of the caregivers in managing the patient as a result of treatment with ITB.

CONCLUSIONS

In patients belonging to level V of Gross Motor Function Classification System and treated with ITB, a decrease in frequency and severity of dystonia is observed. This improvement eases caregiver in patient management.

LEVEL OF EVIDENCE

Therapeutic Level IV.

摘要

背景

现有文献表明,鞘内注射巴氯芬(ITB)治疗可减轻脑瘫(CP)患者的痉挛,并且多项研究表明该治疗也可用于肌张力障碍患者。本研究的目的是评估ITB治疗儿童CP所致肌张力障碍的效果。

方法

收集了19例接受ITB治疗的粗大运动功能分类系统V级婴儿CP患者中因肌张力障碍作为结局的患者数据。植入时的平均年龄为8.49岁。在治疗前以及植入后3、6和12个月使用巴里-奥尔布赖特量表和伯克-法恩-马斯登量表对患者进行评估。

结果

结果显示,仅治疗3个月后,两个量表的总分就有统计学意义的改善(P < 0.001),这种改善在1年的随访期内得以维持。结果还显示,ITB治疗使肌张力障碍减轻、姿势改善,并且护理人员照顾患者的工作变得轻松。

结论

在粗大运动功能分类系统V级且接受ITB治疗的患者中,观察到肌张力障碍的频率和严重程度降低。这种改善使护理人员照顾患者更加轻松。

证据水平

治疗性IV级。

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