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鞘内注射巴氯芬用于可行走的脑瘫儿童

Intrathecal baclofen infusion for ambulant children with cerebral palsy.

作者信息

Brochard Sylvain, Remy-Neris Olivier, Filipetti Paul, Bussel Bernard

机构信息

Department of Physical Medicine and Rehabilitation, Centre Hospitalo-Universitaire Morvan, Brest, France.

出版信息

Pediatr Neurol. 2009 Apr;40(4):265-70. doi: 10.1016/j.pediatrneurol.2008.10.020.

Abstract

This study assessed the effects of continuous intrathecal infusion of baclofen on the gait of ambulant children with cerebral palsy. Details, collected retrospectively before and after pump implantation, included Gillette Functional Assessment Questionnaire score, use of walking aids, Ashworth Scale score, and joint angle at which the stretch reflex was triggered. Twenty-one ambulant children and young adults with cerebral palsy were included. Their mean age was 11 years and 10 months (standard deviation, 4 years and 10 months; range, 6-22 years). The mean length of treatment was 25.8 months (range, 5-75 months). After treatment, the lower-limb Ashworth score decreased by 1.4 points (standard deviation, 0.52), and the Gillette Functional Assessment Questionnaire score increased significantly, from 5.04 (standard deviation, 2.08) to 6.09 (standard deviation, 2.05) (P < 0.05). Seven children were able to use less supportive walking aids. Continuous intrathecal baclofen infusion appears to decrease spasticity and improve the gait capacity of children with cerebral palsy. Prospective, controlled studies are necessary to prove the functional effect of intrathecal baclofen infusion.

摘要

本研究评估了鞘内持续输注巴氯芬对能行走的脑瘫儿童步态的影响。在植入泵之前和之后回顾性收集的详细信息包括吉列特功能评估问卷评分、助行器使用情况、Ashworth量表评分以及引发牵张反射的关节角度。纳入了21名能行走的脑瘫儿童和青年。他们的平均年龄为11岁10个月(标准差为4岁10个月;范围为6 - 22岁)。平均治疗时长为25.8个月(范围为5 - 75个月)。治疗后,下肢Ashworth评分降低了1.4分(标准差为0.52),吉列特功能评估问卷评分显著提高,从5.04(标准差为2.08)提高到6.09(标准差为2.05)(P < 0.05)。7名儿童能够减少对助行器的依赖。鞘内持续输注巴氯芬似乎能降低痉挛程度并改善脑瘫儿童的步态能力。需要进行前瞻性对照研究来证实鞘内输注巴氯芬的功能效果。

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