早产儿脑性瘫痪258例临床研究  

Clinical study of cerebral palsy in 258 preterm infants.

作　　者：侯梅[1] 孙殿荣[1] 单若冰[1] 隋晓峰[1] 王珂[1] 

机构地区：[1]青岛市妇女儿童医疗保健中心神经康复科,山东青岛266011

出　　处：《中国儿童保健杂志》2011年第5期406-408,418,共4页Chinese Journal of Child Health Care

基　　金：青岛市科技发展计划项目(07-2-1-16-nsh)

摘　　要：【目的】探讨早产儿脑瘫的高危因素、脑瘫类型、运动障碍程度、影像学特点及共患病情况。【方法】专科医院为基础的横断面临床研究,研究对象为2006年1月-2010年6月在本院脑瘫康复中心住院治疗的早产儿脑瘫患者,详细记录围生期脑损伤高危因素;采用脑瘫粗大运动功能分级系统(Gross Motor Function Classification System,GM-FCS)评估运动障碍程度;常规进行智力评测、眼科学检查、语言能力评估,怀疑听觉障碍进行脑干听觉诱发电位行听力阈值测试,采用SPSS13.0统计软件进行统计学处理。【结果】早产儿脑瘫以痉挛型最多见(占77.13%)。痉挛型双瘫和偏瘫的GMFCS水平好于不随意运动型、四肢瘫和混合型(F=4.362,P<0.01)。不同脑瘫类型和GMFCS水平的患儿共患病明显不同。占65.89%患儿影像学呈现侧脑室周围白质软化改变,见于各种类型但以痉挛型双瘫和四肢瘫最多,早期影像学检查有利于早产儿脑瘫的早期诊断、分型和预后预测。【结论】认识并掌握早产儿脑瘫的运动学和影像学特征以及各种伴发障碍,对于病因学研究、综合康复管理都极端重要。【Objective】 To investigate the related risk factors、clinical types distributions、the level of movement disorder and neuroimaging characters、the comorbiditie in preterm infants with cerebral palsy（CP）.【Methods】 A clinical study of cross section based on Qingdao special hospital.The preterm children with cerebral palsy hospitalized in rehabilitation center from January 2006 to June 2010 were studied.Perinatal data were collected by the researchers using the questionnaire and meeting with children＇s mother;Gross Motor Function Classification System（GMFCS） was adopted to evaluate the levels of movement disorder;every children accepted the intelligence test,eye examination and speech evaluation.And the children who were suspected with auditory disorders had brain stem auditory evoked potential examination.【Results】 Among the 258 cases,199 cases with spastic type CP.The levels of GMFCS of spastic diplegia and hemiplegia were better than the dyskinetic、spastic tetraplegia and the mixed type（F=4.362,P0.01）.The distributions of comorbidites were different between the different types of cerebral palsy and the levels of GMFCS.170 cases（65.89%） with cerebral palsy had periventricular leukomalacia（PVL） which could be seen in all types of CP but more frequently in the spastic diplegia and tetraplegia.These can benefit the early screening and early diagnose of CP of premature and also help the localization and qualitation of the comorbidities.【Conclusions】 CP together with associated disorders become the focus of premature infants.It is important to recognize the clinical aspects,neuroimaging features and the comorbidities of them for etiological research and general rehabilitation administration.

关 键 词：早产儿 脑瘫 侧脑室周围白质软化 共患病 

分 类 号：R722.1[医药卫生—儿科]