标题：选择性脊神经后根切断术配合强制性诱导运动训练对脑性瘫痪患儿肢体功能及血清学指标的影响

      作者：陈章明 1，2，周孙章 1，2
    （1.福建医科大学康复治疗学系，福建 福州 350005；
2.福州儿童医院骨科，福建 福州 350005）

      卷次： 2015年26卷6期

      【摘要】 目的 分析腰骶部选择性脊神经后根切断术配合强制性诱导运动训练对脑性瘫痪患儿肢体功能
以及血清学指标的影响。方法 选择在本院接受住院治疗的脑性瘫痪患儿76例作为研究对象，随机分为接受常
规治疗的对照组和接受腰骶部选择性脊神经后根切断术配合强制性诱导运动训练的观察组，每组各38例。比较
两组患儿的肢体功能、血清TORCH抗体水平、血清神经元特异性烯醇化酶及炎症因子水平等差异。结果 (1)观
察组患者接受治疗后的临床痉挛指数(CSI)评分低于对照组，粗大运动功能量表(GMFM)评分及步行速度大于对
照组(P<0.05)；(2)观察组患者接受治疗后的CMV-IgM、TOX-IgM、HSV2-IgM、RV-IgM水平均明显低于对照组(P<
0.05)；(3)观察组患者接受治疗后的NSE、IFN-γ水平低于对照组、IL-4水平高于对照组(P<0.05)。结论 腰骶部
选择性脊神经后根切断术配合强制性诱导运动训练可以提高脑性瘫痪患儿的肢体运动能力，降低TORCH抗体
水平，平衡细胞因子分泌。

      【关键词】 脑性瘫痪；选择性脊神经后根切断术；强制性诱导运动训练

      【中图分类号】 R726 【文献标识码】 A 【文章编号】 1003—6350（2015）06—0816—04


Effect of selective lumbosacral posterior rhizotomy combined with constraint-induced movement therapy on
limb function and serological indexes in patients with cerebral palsy.
CHEN Zhang-ming 1,2, ZHOU Sun-zhang 1,2.
1. Department of Rehabilitation, Fujian Medical University, Fuzhou 350005, Fujian, CHINA; 2. Department of
Orthopedics, Fuzhou Children's Hospital, Fuzhou 350005, Fujian, CHINA

【Abstract】 Objective To analyze the effect of selective lumbosacral posterior rhizotomy combined with con-
straint-induced movement therapy on limb function and serological indexes in patients with cerebral palsy. Methods Sev-
enty-six children with cerebral palsy in our hospital were selected as research objects, which were randomly divided in-
to control group (conventional treatment) and observation group (selective lumbosacral posterior rhizotomy combined
with constraint-induced movement therapy), each with 38 cases. Physical function, serum TORCH antibody levels, se-
rum NSE and inflammatory factor levels were compared between the two groups. Results (1) After treatment, the pa-
tients' CSI score in the observation group was significantly lower than that in the control group, and GMFM score and
walking speed were significantly greater (P<0.05); (2) Patients' CMV-IgM, TOX-IgM, HSV2 IgM, RV IgM levels af-
ter treatment in the observation group were significantly lower than those in the control group (P<0.05); (3) After treat-
ment, patients' serum NSE, IFN-γ levels in the observation group were significantly lower than those in the control
group, while IL-4 level was significantly higher (P<0.05). Conclusion Selective lumbosacral posterior rhizotomy
combined with constraint-induced movement therapy could improve limb motor ability of children with cerebral palsy,
reduce TORCH antibody levels, and balance secretion of cytokines.

      【Key words】 Cerebral palsy; Selective lumbosacral posterior rhizotomy; Constraint-induced movement therapy
基金项目：福州市政府科技攻关项目（编号：2003-26）