258例早产儿脑性瘫痪病因诊断的探讨  

Exploration of Etiology and Diagnose of 258 Cases of The Premature Cerebral Palsy

作　　者：秦勤[1] 程锐[1] 蒋小镛[1] 赵卫华[1] 

机构地区：[1]南京医科大学附属南京儿童医院,江苏南京210008

出　　处：《中国伤残医学》2008年第6期18-20,共3页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的:探讨早产儿脑性瘫痪的病因诊断以利防治。方法:对2002年11月～2005年12月我院早期干预门诊经确诊258例早产儿脑瘫分析其病因、早期临床表现及头颅CT象征,进行体格神经系统检查并智测。结果:(1)异常分娩史124例(46.1%),高危因素以窒息、HIE、ICH、高胆、肺部疾病、感染、惊厥为主,各为121例、65例、58例、78例、43例、66例、12例。(2)6个月以内确诊的脑瘫28例的临床表现,以反应差、嗜睡、少吃、哭、动,肌张力低下或增高,反射及姿势异常,发育明显落后。(3)身长、体重、头围、MDI和PDI各为73.24cm±9.82cm、9.12kg±2.31kg、44.15cm±3.47cm、44.42分±6.09分、43.80分±4.95分。(4)头颅CT表现异常率为95.4%。(5)发育落后,258例早产儿脑瘫发育落后情况,身长、体重、头围(<2SD)各为123例、90例、148例,MDI、PDI>70分各为5、4例,余均<50分,癫痫3例,语言落后78例,听力障碍42例。结论:当早产儿具有高危因素,异常临床表现与神经症状、发育明显落后,应结合头颅CT密切随访可早期诊断脑性瘫痪及早干预。objective：To explore the etiology and early diagnose of the premature cerebral palsy. Methods： 258 cases were diagnosed premature cerebral palsy and every infant was given physical neurological examination, intelligence test（CDCC） and cranial CT examination. Results： 1. The high risk factors of the premature infant were asphyxia,hypoxie--ischemic encephalopathy,in- traeranial hemorrhage, hyperbilirubinemia, pulmonary diseases, Infectious disease and convulsion 121,65,58,78,43,66,12 cases each. 2. The clinical features of was diagnosed within 6 months old of 28 cases were poor feeding , crying,moving, reaction, somn- dense,hypotonic,abnormal posture,and reflex. 3. Physical and intelligence developments in 258 cases of cerebral palsy in body head length（cm） body weight（kg） head eircumferenee（cm） MDI and PDI（mark） were 73.24± 9.28,9.12 ± 2.31,44.15 ± 3.47, 44.42±6.09,43.80±4.95 each. 4. The abnormality features of cranial CT scan was 95.4%. 5. Development retardation body length （cm） body weight（kg） headcircumference（cm）（〈2SD） were 123, 90, 148cases, MDI and PDI（marks） were all 〈50 except 5 and 4 cases 〉70. Epilepsy,language,auditory retardations were 3,78,42 cases each. Conclusion： Premature cerebral palsy could be early diagnosed if the infant has high risk factors with physical intelligence retardation developments and abnormal clinical neurological menifestions with abnormal cranial CT scan. Early intervention should be given.

关 键 词：病因 诊断 脑性瘫痪 早产儿 

分 类 号：R722.1[医药卫生—儿科]