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潘志良,黎锦灵,单敏瑜.石膏固定与足外展矫形器治疗脑瘫患儿马蹄内翻足的临床研究[J].中国医药科学,2018,(3):9-12        基金项目:广东省医学科研基金项目(B2015091)
石膏固定与足外展矫形器治疗脑瘫患儿马蹄内翻足的临床研究
Clinical study of cast immobilization and foot abduction orthosis in treatment of talipes equinovarus in children with cerebral palsy
  
DOI:
中文关键词:  石膏固定;足外展矫形器;脑瘫;马蹄内翻足
英文关键词:Cast immobilization;Foot abduction orthosis;Cerebral palsy;Talipes equinovarus
作者单位
潘志良,黎锦灵,单敏瑜 广州市社会福利院康复医院康复医学科 
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中文摘要:
      目的 探讨石膏固定与足外展矫形器对脑瘫患儿马蹄内翻足的治疗效果。 方法 选取 2014 年 1月~ 2015 年 6 月期间广州市社会福利康复医院收治的 32 例马蹄内翻足脑瘫患儿为受试对象,按照入院顺序随机分为观察组与对照组各 16 例。对照组患儿实施脑瘫肢体综合训练治疗,而观察组患儿则在其基础上予以石膏固定结合足外展矫形器进行治疗。比较治疗前及治疗 1 年后两组患儿步态功能 [Tinetti 步态评分量表(TGA)]、踝关节被动形态(屈膝位双踝关节被动背屈角度、伸膝位双踝关节被动背屈角度)、步态时空参数(支撑相、摆动相、步长、步速)变化,分析治疗 1 年内两组患儿跟腱复发挛缩情况差异。 结果 治疗 1 年后,观察组患儿 TGA 评分、摆动相、步长、步速水平较治疗前有显著提升,且明显高于对照组(P 均< 0.05);观察组患儿屈、伸膝位双踝关节被动背屈角、支撑相水平均较治疗前有显著下降,且明显低于对照组(P 均< 0.05)。治疗 1 年内,观察组患儿跟腱复发挛缩率明显低于对照组(P < 0.05)。 结论 石膏固定与足外展矫形器治疗脑瘫患儿马蹄内翻足可取得较为理想的效果,有利于步行功能预后恢复。
英文摘要:
      Objective To explore the treatment effects of cast immobilization and foot abduction orthosis in treatment of talipes equinovarus in children with cerebral palsy. Methods Thrity-two cases of cerebral palsy children with talipes equinovarus treated in Guangzhou Social Welfare Rehabilitation Hospital from January 2014 to June 2015 were selected for the study and randomly divided into the observation group and the control group with 16 cases in each group according to the order of admission.The control group was treated with comprehensive training of cerebral palsy limbs,and the observation group was treated with cast immobilization and foot abduction orthosis on this basis.The gait function[Tinetti gait rating scale(TGA)],ankle joint passive shape(flexion ankle passive dorsiflexion angle and extension ankle passive dorsiflexion angle),the temporal and spatial parameters(support phase,swing phase,step size,pace)were compared between the two groups before and after 1 year of treatment,the Achilles tendon recurrence contracture within 1 year was analyzed in the two groups. Results After 1 year of treatment,the levels of TGA score,swing phase,length and pace in the observation group were significantly improved compared with those before treatment,and the levels were significantly higher than those in the control group (all P < 0.05).The levels of the flexion or extension ankle passive dorsiflexion angle and the support phase were decreased significantly in the observation group compared with those before treatment,and the levels were significantly lower than those in the control group(all P < 0.05).Within 1 year of treatment, the Achilles tendon recurrence contracture rate in the observation group was significantly lower than that in the control group(P < 0.05). Conclusion Cast immobilization and foot abduction orthosis can achieve an ideal effect on talipes equinovarus in children with cerebral palsy,and it is beneficial to the prognosis of walking function.
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