论文部分内容阅读
目的研究选择性脊神经后根部分切断术治疗偏侧肢体痉挛性瘫痪患儿下肢痉挛的疗效及对血清神经元特异性烯醇化酶(neuron-specific enolase,NSE)、转化生长因子β1(human transforming growth factorβ1,TGF-β1)浓度的影响。方法选取2014年3月至2015年12月我院收治的偏侧肢体痉挛性瘫痪患儿40例为观察对象,所有患儿均采用选择性脊神经后根部分切断术,比较治疗前后患侧下肢肌群张力和患儿基底节区代谢产物水平。结果小腿三头肌群、腘绳肌、髋内收肌群手术前的肌张力均显著高于手术后的肌张力(P<0.05)。对侧基底节区Cho/NAA术后较术前升高,而NAA/Cr较术前降低,具有显著性差异(均P<0.05)。术后患儿NSE水平为(16.4±4.1)μg/L,明显低于术前的(28.9±8.2)μg/L(P=0.000);而术后TGF-β1水平为(64.2±31.5)ng/L,明显高于术前的(32.4±24.7)ng/L,具有显著性差异(P=0.001)。结论选择性脊神经后根部分切断术治疗偏侧肢体痉挛性瘫痪患儿下肢痉挛的疗效较佳,可有效改善患儿各肌肌群张力,调节血清NSE和TGF-β1水平。
Objective To study the curative effect of partial posterior rhizotomy on the spasticity of lower extremity in children with spastic paralysis of the extremity and its effect on the expression of neuron-specific enolase (NSE), transforming growth factor-β1 factor β1, TGF-β1) concentration. Methods From March 2014 to December 2015, 40 children with spastic paralyzed limbs in our hospital were enrolled in this study. All children underwent partial posterior root dorsal rhizotomy. Compared with the control group, Group tension and basal ganglia metabolic products in children. Results The muscle tension of the triceps, hamstring and hip adductor muscles before operation were significantly higher than those after operation (P <0.05). Cho / NAA in the contralateral basal ganglia was higher than that before the operation, while NAA / Cr was significantly lower than that before the operation (all P <0.05). The level of NSE in postoperative children was (16.4 ± 4.1) μg / L, which was significantly lower than that of preoperative (28.9 ± 8.2) μg / L (P = 0.000), while the level of TGF-β1 was (64.2 ± 31.5) ng / L, significantly higher than the preoperative (32.4 ± 24.7) ng / L, with significant difference (P = 0.001). Conclusions Selective posterior rhizotomy with partial posterior rhizotomy is effective in treating lower extremity spasticity in children with spastic paralyzed limbs. It can effectively improve muscle tone and regulate serum NSE and TGF-β1 in children.