目的 對比分析多點靶肌注射與非多點靶肌注射A型肉毒毒素對小兒痙攣型腦性癱瘓的臨床效果。方法 選擇2013年3月-2016年3月在河南中醫(yī)藥大學(xué)第一附屬醫(yī)院進行診治的小兒痙攣型腦性癱瘓患者118例，隨機分為兩組，每組各59例。對照組采用非多點靶肌注射A型肉毒毒素治療，觀察組采用多點靶肌注射A型肉毒毒素治療，比較兩組治療前、治療1個月、治療3個月、治療6個月以及治療12個月的改良Ashworth評分、CSS評分和GMFM評分。結(jié)果 治療后兩組的改良Ashworth評分均明顯降低，同組治療前后比較差異有統(tǒng)計學(xué)意義（P < 0.05）；治療12個月后比較，觀察組明顯低于對照組，差異有統(tǒng)計學(xué)意義（P < 0.05）。治療后兩組的CSS評分均明顯降低，同組治療前后比較差異有統(tǒng)計學(xué)意義（P < 0.05）；但兩組間無明顯差異。治療后兩組的GMFM評分均明顯升高，同組治療前后比較差異有統(tǒng)計學(xué)意義（P < 0.05）；但兩組間無明顯差異。結(jié)論 多點靶肌注射與非多點靶肌注射A型肉毒毒素對小兒痙攣型腦性癱瘓均具有顯著的臨床治療效果，且多點靶肌注射Ashworth評分優(yōu)于非多點靶肌注射，更加有效緩解患兒的肢體痙攣程度，改善粗大運動能力。

Objective To explore the clinical effects of multipoint injection and nonmultipoint injection of Botulinum Toxin type A in children with spastic cerebral palsy. Methods 118 children with spastic cerebral palsy were enrolled in our hospital from March 2013 to March 2016, and were randomly divided into two groups (n= 59). The control group was treated with nonmultipoint injection of Botulinum Toxin type A, the observation group using multipoint injection of Botulinum Toxin type A. The improved Ashworth score, CSS score, and GMFM score were compared between the two groups before treatment, 1 month after treatment, 3 months after treatment, 6 months of treatment, and 12 months of treatment. Results The improved Ashworth scores of the two groups were significantly lower (P < 0.05), there was significant difference between the two groups after 12 months of treatment. The scores of CSS in the two groups were significantly decreased (P < 0.05), but there was no significant difference between the two groups. The scores of GMFM in both groups were significantly increased (P < 0.05), but there was no significant difference between the two groups. Conclusion Multipoint injection and nonmultipoint injection of Botulinum Toxin type A on children with spastic cerebral palsy have significant clinical treatment effect, Ashworth scores of multipoint injection is better then nonmultipoint injection, can effectively alleviate the degree of limb spasm in children to improve the ability to exercise.