Krach Linda E
Department of Physical Medicine and Rehabilitation, University of Minnesota, Minneapolis, 55455, USA.
Dev Med Child Neurol. 2009 Oct;51 Suppl 4:106-12. doi: 10.1111/j.1469-8749.2009.03422.x.
Intrathecal baclofen (ITB) is an effective treatment for both spasticity and dystonia in people with cerebral palsy (CP). Its use is becoming increasingly common. ITB is typically associated with fewer side effects than the oral form of the product, but there are risks related to the hardware needed for intrathecal delivery. Much of what has been reported in the literature about ITB is based on experience with children or groups of children and adults; few reports exclusively address its use in adults with CP. These reports indicate that muscle tone is consistently reduced, but there is some variability in functional outcomes. Few well-controlled studies have been done. Controversies remain concerning ITB, including whether a trial is needed before pump implantation, proper catheter tip placement, and programming options, as well as whether it contributes to the development or progression of scoliosis. These and other unanswered questions should be addressed in a systematic way.
鞘内注射巴氯芬（ITB）是治疗脑瘫（CP）患者痉挛和肌张力障碍的有效方法。其应用越来越普遍。与该产品的口服形式相比，ITB通常副作用较少，但鞘内给药所需的硬件存在风险。文献中关于ITB的报道大多基于儿童或儿童与成人组的经验；很少有报告专门探讨其在成年CP患者中的应用。这些报告表明肌张力持续降低，但功能结果存在一定差异。很少有严格对照的研究。关于ITB仍存在争议，包括在植入泵之前是否需要进行试验、导管尖端的正确放置和编程选项，以及它是否会导致脊柱侧弯的发展或进展。这些以及其他未解决的问题应以系统的方式加以解决。
