Zhong Meiling,Chong Qingqing,Chen Dan.Treatment effect of local mass massage to children with congenital muscular torticollis[J].Journal of Clinical Pediatric Surgery,2020,19(12):1113-1117.[doi:10.3969/j.issn.1671-6353.2020.12.010]
先天性肌性斜颈包块局部按摩对治疗效果的影响
- Title:
- Treatment effect of local mass massage to children with congenital muscular torticollis
- Keywords:
- Torticollis/CN; Torticollis/TH; Treatment Outcome
- 分类号:
- R726.8;R682.1+2
- 摘要:
- 目的 比较先天性肌性斜颈患者保守治疗过程中对包块局部按摩与否对临床疗效的影响，以制定规范化的保守治疗方法。方法 选取南京医科大学附属儿童医院骨科2017年1月至2018年6月收治的242例有颈部包块的先天性肌性斜颈患者作为研究对象，随机进行分组，局部按摩组118例，非局部按摩组124例。记录两组患者3月龄时B超下颈部包块大小，比较6月龄和9月龄时两组患者包块消失的比例，比较两组18月龄时具有实施胸锁乳突肌松解手术指征的比例。结果 6月龄时局部按摩组有49例（41.53%）颈部包块消失，非局部按摩组有95例（76.61%）颈部包块消失，差异有统计学意义（χ2=30.891，P<0.001）；9月龄时局部按摩组有102例（86.44%）颈部包块消失，非局部按摩组有123例（99.19%）颈部包块消失，差异有统计学意义（χ2=13.167，P<0.001）；18月龄时，非局部按摩组需要手术的患者有38例，局部按摩组需要手术的患者69例，差异有统计学意义（χ2=18.895，P<0.001）。结论 先天性肌性斜颈患者保守治疗时对包块进行局部按摩会延迟包块自行消退时间，降低患者自愈率，增加手术比例。
- Abstract:
- Objective To compare the clinical efficacy of conservative treatment for local mass massage in children with congenital muscular torticollis (CMT) so as to develop a standardized conservative treatment.Methods From January 2017 to June 2018,a total of 242 hospitalized CMT children were selected and randomly divided into two groups of local mass massage (n=118) and non-local mass massage (n=124).The ultrasonic size of neck was recorded at an age of 3 months.The proportion of disappearance of mass in neck at an age of 6 and 9 months was compared between two groups.The ratio with an indication for sternocleidomastoid muscle release surgery at an age of 18 months was compared between two groups.Results At 6 months of age,neck mass disappeared (n=49,49/118) in local mass massage group versus (n=95,95/124) in non-local mass massage group (χ2=30.891,P<0.001);at an age of 9 months,neck mass disappeared (n=49,102/118) in local mass massage group versus (n=95,123/124) in non-local mass massage group (χ2=13.167,P<0.001);at an age of 18 months,38 cases required surgery in non-local mass massage group versus 69 cases in local mass massage group (χ2=18.895,P<0.001).Conclusion Local mass massage for CMT children during conservative treatment delays the time of mass spontaneous regression,lowers the rate of self-healing and boosted the proportion of surgery.
参考文献/References:
1 Sargent B,Kaplan SL,Coulter C,et al.Congenital muscular torticollis:bridging the gap between research and clinical practice[J].Pediatrics,2019,144(2):e20190582.DOI:10.1542/peds.2019-0582.
2 Amaral DM,Cadilha RPBS,Rocha JAGM,et al.Congenital muscular torticollis:where are we today? A retrospective analysis at a tertiary hospital[J].Porto Biomed J,2019,4(3):e36.DOI:10.1097/j.pbj.0000000000000036.
3 Han MH,Kang JY,Do HJ,et al.Comparison of clinical findings of congenital muscular torticollis between patients with and without sternocleidomastoid lesions as determined by ultrasonography[J].J Pediatr Orthop,2019,39(5):226-231.DOI:10.1097/BPO.0000000000001039.
4 Keklicek H,Uygur F.A randomized controlled study on the efficiency of soft tissue mobilization in babies with congenital muscular torticollis[J].J Back Musculoskelet Rehabil,2018,31(2):315-321.DOI:10.3233/BMR-169746.
5 石玥,柯洵,丁洪磊.崔述生治疗小儿肌性斜颈经验总结[J].中国中医药信息杂志,2015,22(4):114-115.DOI:10.3969/j.issn.1005-5304.2015.04.035. Shi Y,Ke X,Ding HL.Cui Shusheng’s experience of treating children with muscular torticollis[J].Chinese Journal of Information on Traditional Chinese Medicine,2015,22(4):114-115.DOI:10.3969/j.issn.1005-5304.2015.04.035.
6 Heidenreich E,Johnson R,Sargent B.Informing the Update to the Physical Therapy Management of Congenital Muscular Torticollis Evidence-Based Clinical Practice Guideline[J].Pediatr Phys Ther,2018,30(3):164-175.DOI:10.1097/PEP.0000000000000517.
7 黄程军,唐盛平,付桂兵,等.120例先天性肌性斜颈术后的长期随访[J].临床小儿外科杂志,2013,12(6):454-457,470.DOI:10.3969/j.issn.1671-6353.2013.06.007. Huang CJ,Tang SP,Fu GB,et al.Long-term follow-up of surgical treatment for congenital muscular torticollis,120 cases report[J].J Clin Ped Sur,2013,12(6):454-457,470.DOI:10.3969/j.issn.1671-6353.2013.06.007.
8 Zollars JA,Burtner PA,Stockman G,et al.Neural and visceral manipulation in infants with congenital muscular torticollis:a feasibility study[J].J Phys Ther Sci,2020,32(1):7-15.DOI:10.1589/jpts.32.7.
9 赵章帅,唐盛平,王帅印,等.2124例婴儿斜颈首诊的临床流行病学分析[J].临床小儿外科杂志,2013,12(1):45-46.DOI:10.3969/j.issn.1671-6353.2013.01.012. Zhao ZS,Tang SP,Wang SY,et al.Infantile torticollis:A prospective clinical epidemiological study of [2124] cases[J].J Clin Pediatr Sur,2013,12(1):45-46.DOI:10.3969/j.issn.1671-6353.2013.01.012.
10 Hwang D,Shin YJ,Choi JY,et al.Changes in muscle stiffness in infants with congenital muscular torticollis[J].Diagnostics (Basel),2019,23,9(4):E158.DOI:10.3390/diagnostics9040158.
11 Fenton R,Gaetani S,MacIsaac Z,et al.Description of mandibular improvements in a series of infants with congenital muscular torticollis and deformational plagiocephaly treated with physical therapy[J].Cleft Palate Craniofac J,2018,55(9):1282-1288.DOI:10.1177/1055665618763374.
12 He L,Yan X,Li J,et al.Comparison of 2 Dosages of stretching treatment in infants with congenital muscular torticollis:a randomized trial[J].Am J Phys Med Rehabil,2017,96(5):333-340.DOI:10.1097/PHM.0000000000000623.
13 赵章帅,唐盛平,熊竹.婴儿先天性肌性斜颈保守综合治疗1142例[J].临床小儿外科杂志,2016,15(6):551-557.DOI:10.3969/j.issn.1671-6353.2016.06.009. Zhao ZS,Tang SP,Xiong Z.Comprehensive treatment of infants with congenital muscular torticollis:a report of [1142] cases[J].J Clin Ped Sur,2016,15(6):551-557.DOI:10.3969/j.issn.1671-6353.2016.06.009.
14 Limpaphayom N,Kohan E,Huser A,et al.Use of combined botulinum toxin and physical therapy for treatment resistant congenital muscular torticollis[J].J Pediatr Orthop,2019,39(5):e343-e348.DOI:10.1097/BPO.0000000000001302.
15 Petronic I,Brdar R,Cirovic D,et al.Congenital muscular torticollis in children:distribution,treatment duration and outcome[J].Eur J Phys Rehabil Med,2010,46(2):153-157.
16 Lee K,Chung E,Lee BH.A comparison of outcomes of asymmetry in infants with congenital muscular torticollis according to age upon starting treatment[J].J Phys Ther Sci,2017,29(3):543-547.DOI:10.1589/jpts.29.543.
17 He L,Yan X,Li J,et al.Comparison of 2 dosages of stretching treatment in infants with congenital muscular torticollis:a randomized trial[J].Am J Phys Med Rehabil,2017,96(5):333-340.DOI:10.1097/PHM.0000000000000623.
18 Cheng JC,Chen TM,Tang SP,et al.Snapping during manual stretching in congenital muscular torticollis[J].Clin Orthop Relat Res,2001,(384):237-244.DOI:10.1097/00003086-200103000-00028.
19 Huegel M,Kenyon LK.Application of the Clinical Practice Guideline for Congenital Muscular Torticollis:a case report[J].Pediatr Phys Ther,2019,31(1):E1-E5.DOI:10.1097/PEP.0000000000000569.
20 Kaplan SL,Coulter C,Sargent B.Physical therapy management of congenital muscular torticollis:A [2018] Evidence-Based Clinical Practice Guideline From the APTA Academy of Pediatric Physical Therapy[J].Pediatr Phys Ther,2018,30(4):240-290.DOI:10.1097/PEP.0000000000000544.
21 Gundrathi J,Cunha B,Mendez MD.Congenital torticollis[M/OL].(2019-09-02)[2020-02-29].https://www.ncbi.nlm.nih.gov/books/NBK549778/
22 余一,许丽.推拿治疗小儿先天性肌性斜颈的临床研究进展[J].广西中医药大学学报,2016,19(1):100-101. Yu Y,Xu L.Clinical research progress of massage therapy for congenital muscular torticollis in children[J].Journal of Guangxi University of Chinese Medicine,2016,19(1):100-101.
23 孙德仁,夏慧萍,陈博睿,等.小儿肌性斜颈病因与少儿推拿治疗概述[J].实用中医药杂志,2018,34(9):1138-1140.DOI:10.3969/j.issn.1004-2814.2018.09.100. Sun DR,Xia HP,Chen BR,et al.Etiology of infantile muscular torticollis and overview of pediatric massage therapy[J].Journal of Practical Traditional Chinese Medicine,2018,34(9):1138-1140.DOI:10.3969/j.issn.1004-2814.2018.09.100.
24 Cheng JC,Wong MW,Tang SP,et al.Clinical determinants of the outcome of manual stretching in the treatment of congenital muscular torticollis in infants:a prospective study of eight hundred and twenty-one cases[J].J Bone Joint Surg Am,2001,83(5):679-687.DOI:10.2106/00004623-200105000-0000.
25 Kim SM,Cha B,Jeong KS,et al.Clinical factors in patients with congenital muscular torticollis treated with surgical resection[J].Arch Plast Surg,2019,46(5):414-420.DOI:10.5999/aps.2019.00206.
相似文献/References:
[1]唐盛平,周亚玲,刘正全,等.先天性肌性斜颈病变组织中细胞凋亡的研究[J].临床小儿外科杂志,2007,6(01):12.
[2]于忠勤 徐建国 石英佐 樊剑锋 朱晓敏 宣晓琪. 内镜下手术治疗儿童先天性肌性斜颈11例分析[J].临床小儿外科杂志,2011,10(04):282.
[J].Journal of Clinical Pediatric Surgery,2011,10(12):282.
[3]黄程军 唐盛平 付桂兵. 120例先天性肌性斜颈术后的长期随访[J].临床小儿外科杂志,2013,12(06):454.
[4]赵章帅,唐盛平,熊竹..婴儿先天性肌性斜颈保守综合治疗1 142例[J].临床小儿外科杂志,2016,15(06):551.
[J].Journal of Clinical Pediatric Surgery,2016,15(12):551.
备注/Memo
收稿日期:2020-02-05。
作者简介:钟美玲,Email:meilingzhong66@163.com