颈总动脉周围交感神经网剥脱切除术对学龄前脑瘫患儿头部血供及认知情况的影响  

Effects of sympathectomy of carotid artery on cognitive conditions and brain blood supply in preschool children with cerebral palsy

作　　者：于江龙 买尔阿芭[2] 木塔力甫·努热合买提[2] 艾克拜尔·哈力克[2] 刘亮[2] 栾新平[2] 

机构地区：[1]新疆巴州人民医院神经外科 [2]新疆医科大学第二附属医院神经外科,乌鲁木齐830063

出　　处：《中华神经外科杂志》2015年第3期277-280,共4页Chinese Journal of Neurosurgery

摘　　要：目的 探讨颈总动脉周围交感神经网剥脱切除术对学龄前脑瘫患儿头部血供及认知情况影响.方法 纳入45例学龄前脑瘫患儿,分为手术组和未手术组.手术组23例,平均年龄4.8岁.未手术组22例,平均年龄4.5岁.采集手术组患儿术前、术后2周、术后6个月的经颅多普勒（TCD）各指标,并收集手术组及未手术组患儿术前、术后2周、术后6个月的的发育商、智商及C因子指标.结果 与术前相比,脑瘫患儿术后2周大脑中动脉的平均流速、峰值流速、舒张末流速显著增加[分别为（87.62 ±6.12） em/s对比（96.34±7.24） em/s,（134.36±10.26） em/s对比（149.02±11.23） em/s,（54.55±9.22） em/s对比（60.07±10.24） em/s,均P＜0.05],血管搏动指数和血管阻力指数显著小于对照组（分别为0.97±0.09对比0.85±0.17,0.67±0.02对比0.57±0.03,均P＜0.05）,这种差异在术后6个月后仍存在.术后2周时,手术组与未手术组患儿的发育商、智商、C因子无明显差异（分别为54.02±8.25对比54.66±13.44,59.02±8.25对比60.66±13.44,8.97±2.66对比9.56±2.71,均P＞0.05）;术后6个月后,手术组与未手术组患儿的发育商、智商、C因子的差异均有统计学意义（手术组比未手术组,83.40±11.28对比61.43±12.72,80.40±11.28对比67.43±12.72,12.78±3.89对比9.99±3.25,均P＜0.01）,手术组各项认知学指标大于未手术组.结论 颈总动脉周围交感神经网剥脱切除术能够显著改善学龄前患儿脑供血及发育商、智商、C因子等认知学指标.Objective To evaluate the effects of sympathectomy of carotid artery on cognitive conditions and brain blood supply in preschool children with cerebral palsy.Methods A total of 45 preschool children with cerebral palsy were enrolled,they were divided into surgical group and non-surgical group.Twenty-three patients were in surgery group with the mean age of 4.8 years.Twenty-two patients were in non-surgery group with average age of 4.5 years.Two weeks and six months after surgery,the transcranial doppler （TCD） data were collected in surgical group.Meanwhile,the developmental quotient （DQ）,intelligence quotient（IQ） and C-factor were also collected in surgery surgical group and non-surgery group.Results In surgery group,the average flow velocity,peak velocity,end-diastolic flow velocity at two weeks after the surgery were significantly greater than those before surgery[before surgery vs 2 weeks after surgery,（87.62±6.12） em/s vs （96.34 ± 7.24） em/s,（134.36 ± 10.26）em/s vs （149.02 ± ll.23）em/s,（54.55 ± 9.22） em/s vs （60.07 ± 10.24） em/s,all P 〈 0.05],the vascular pulsation index and vascular resistance index two weeks after the surgery were significantly lower than those TCD index before surgery （before surgery vs 2 weeks after surgery,0.97 ±0.09 vs 0.85 ±0.17,0.67 ±0.02 vs 0.57 ±0.03,all P 〈 0.05）,this difference still existed 6 months after surgery.Two weeks after surgery,the DQ,IQ,C factor in both surgical group and non-surgical group showed no significant difference （surgery group vs non-surgery group,54.02 ± 8.25 vs 54.66 ± 13.44,59.02 ± 8.25 vs 60.66 ± 13.44,8.97 ± 2.66 vs 9.56 ± 2.71,all P 〉 0.05）.At 6 months after the surgery,the DQ,IQ,C factor in both surgical group and non-surgical group showed significant difference （surgery group vs non-surgery group,83.40 ± 11.28 vs 61.43 ± 12.72,80.40 ± 11.28 vs 67.43 ± 12.72,12.78 ±3.89 vs 9.99 ±3.25,all P 〈0.01）.The cognitive index in the surgery group were significant greater than those in

关 键 词：脑瘫 交感神经切除术 颈总动脉 经颅多普勒 认知 发育商 智商 C因子 

分 类 号：R726.5[医药卫生—儿科]