Abstract: ObjectiveTo study the curative effect of the selective posterior lumbar rhizotomy for children with spastic paralysis of the lower extremities spasm and to explore the changes of serum neuron specific enolization enzyme(NSE)and transforming growth factor-beta 1(TGF-β1)．MethodsFrom March 2014 to December 2015，there were 40 children with lower limb spasm underwent selective posterior lumbar rhizotomy．Their Cho/Cr、Cho/NAA、NAA/Cr ratio in the basal ganglia using PRESS135 and PRESS35 sequence，and serum NSE and TGFβ1 level were studied．ResultsAfter operation，the muscle tensions of leg triceps，hamstrings and hip adduction muscles obviously decreased(all P ＜0．05)．Cho/NAA of the contra-lateral basal ganglia region increased，while NAA/Cr decreased simultaneously(P ＜0．05)．The postoperative serum level of NSE was(16．4 ±4．1) μg/L，which was lower than(28．9 ±8．2) μg/L of pre-peration，and TGFβ1 was(32．4 ±24．7)ng/L，which was lower than(64．2 ±31．5)ng/L of pre-peration(P ＜0．05)．ConclusionIt is demonstrated of good clinical effects of the selective posterior lumbar rhizotomy for children with spastic paralysis of the lower extremities spasm，which can both improve the children＇s symptoms，and regulate serum NSE and TGFβ1 levels．
艾克拜尔·哈里克，逯霞，许健，闫宝锋，木塔力甫·努热合买提，买尔阿芭，栾新平. 选择性脊神经后根部分切断术治疗下肢痉挛性瘫痪的疗效及血清NSE、转化生长因子β1浓度的变换[J]. 中国现代手术学杂志, 2017, 21(2): 149-152.
Aikebaier· Halike. The Changes of Serum NSE and TGF-β1 After Selective Posterior Lumbar Rhizotomy for Children with Cerebral Palsy. Chinese Journal of Modern Operative Surgery, 2017, 21(2): 149-152.
［1]Grunt S，Fieggen AG，Vermeulen RJ，et al．Selection criteria for selective dorsal rhizotomy in children with spastic cerebral palsy:a systematic review of the literature［J]．Dev Med Child Neurol，2014，56(4):302-312．［2]张艳娇，童光磊，周陶成，等．超声定位引导A型肉毒毒素注射联合常规康复训练治疗痉挛型脑瘫儿童下肢肌张力障碍的疗效观察［J]．中国儿童保健杂志，2016，24(7):759-762．［3]Chen YP，Pope S，Tyler D，et al．Effectiveness of constraintinduced movement therapy on upper-extremity function in children with cerebral palsy:a systematic review and meta-analysis of randomized controlled trials［J]．Clin Rehabil，2014，28(10):939-953．［4]桑林，马延山，郑重，等．选择性腰骶段脊神经后根部分切断术治疗脑瘫性下肢痉挛的临床观察［J]．中国微侵袭神经外科杂志，2012，17(7):299-301．［5]Abdel Ghany WA，Nada M，Mahran MA，et al．Combined Anterior and Posterior Lumbar Rhizotomy for Treatment of Mixed Dystonia and Spasticity in Children With Cerebral Palsy［J]．Neurosurgery，2016，79(3):336-344．［6]邵旭，于炎冰，张黎，等．腰骶段选择性脊神经后根切断术治疗脑瘫性下肢痉挛状态的远期疗效分析［J]．中华神经外科杂志，2014，30(9):912-916．［7]木塔力甫·努热合买提，闫宝锋，艾克拜尔·哈里克，等．圆锥部选择性脊神经后根部分切断术治疗下肢痉挛型脑性瘫痪的疗效分析［J]．中华实用儿科临床杂志，2016，31(23):1813-1816．［8]段宇，张发永．选择性脊神经根部分切断术对痉挛性偏侧肢体脑瘫患儿基底节区脑代谢影响［J]．中风与神经疾病杂志，2016，33(10):882-885．［9]McConnell K，Johnston L，Kerr C．Efficacy and acceptability of reduced intensity constraint-induced movement therapy for children aged 9-11 years with hemiplegic cerebral palsy:a pilot study［J]．Phys Occup Ther Pediatr，2014 ，34(3):245-259．［10]Staudt M，Berweck S．Is constraint-induced movement therapy harmful in unilateral spastic cerebral palsy with ipsilateral corticospinal projections? ［J]．Dev Med Child Neurol，2014，56(3):202-203．［11]Yang L，Li D，Chen S．Hydrogen water reduces NSE，IL-6，and TNF-α levels in hypoxic-ischemic encephalopathy［J]．Open Med(Wars)，2016，11(1):399-406．［12]Costantine MM，Weiner SJ，Rouse DJ，et al．Umbilical cord blood biomarkers of neurologic injury and the risk of cerebral palsy or infant death ［J]．Int J Dev Neurosci，2011，29(8):917-922．［13]陶维元，卢祖能，文芳，等．神经发育疗法对脑瘫患儿转化生长因子β1和神经重塑的影响［J]．中华临床医师杂志(电子版)，2013，45(15):7228-723．［14]陶维元，文芳，张鸿．脑性瘫痪患儿转化生长因子β1水平的变化及其临床意义［J]．中华物理医学与康复杂志，2010，32(01):54-57．［15]Shi LM，Chen RJ，Zhang H，et al．Cerebrospinal fluid neuron specific enolase，interleukin-1β and erythropoietin concentrations in children after seizures［J]．Childs Nerv Syst．2017，33(5):805-811．［16]Tao W，Lu Z，Wen F．The Influence of Neurodevelopmental Treatment on Transforming Growth Factor-β1 Levels and Neurological Remodeling in Children With Cerebral Palsy［J]．J Child Neurol，2016，31(13):1464-1467．［17]Reimunde P，Rodicio C，López N，et al．Effects of recombinant growth hormone replacement and physical rehabilitation in recovery of gross motor function in children with cerebral palsy［J]．Ther Clin Risk Manag，2010，6:585-592．
2017, Vol. 21 
