2100例脑性瘫痪患者的临床特征及产前危险因素分析  

Prenatal risk factors causing cerebral palsy and clinical characteristics: An analysis of 2100 cases

作　　者：王耸 程洪斌[1] 王晓东[1] 伊龙[1] 王培申 夏义欣[2] 安沂华[1] WANG Song;CHENG Hongbin;WANG Xiaodong;YI Long;WANG Peishen;XIA Yixin;AN Yihua(Department of Functional Neurosurgery, General Hospital of Chinese People's Armed Police Force, Beijing 100039, China;Department of Obstetrics and Gynecology, General Hospital of Chinese People's Armed Police Force, Beijing 100039, China)

机构地区：[1]武警总医院功能神经外科,北京100039 [2]武警总医院妇产科,北京100039

出　　处：《中华灾害救援医学》2018年第1期24-29,共6页Chinese Journal of Disaster Medicine

摘　　要：目的分析脑性瘫痪(脑瘫)患者的临床特征及产前危险因素,为其预防、早期诊断及治疗提供科学依据。方法以武警总医院功能神经外科2012-10至2016-05收治的2 100例脑瘫患者为研究对象(观察组),同时从我院产科选择等量且年龄、性别相匹配的正常产儿作为对照组。回顾性分析观察组脑瘫患者的临床特征,并比较两组在产前的差异及脑瘫形成的影响因素。结果 2 100例脑瘫患者中,平均年龄(7.43±6.21)岁,男1 390例(66.19%),女710例(33.81%)。其中痉挛型脑瘫最常见,占74.10%(1 556/2 100),粗大运动功能分级系统(Gross Motor Function Classification System,GMFCS)分级Ⅱ级最为多见,占860例(40.62%)。剖宫产747例(35.57%),顺产1 353例(64.43%)。产前危险因素分析显示观察组早产、宫内窘迫、多胎妊娠、高龄产妇、孕期感染、妊高症及子痫等因素显著高于对照组,组间差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示早产、宫内窘迫、多胎、高龄产妇、妊高症及子痫为影响脑瘫发生的独立产前危险因素。结论脑瘫是多种危险因素共同作用的结果,产前因素在脑瘫发病中起着重要的作用,其中早产、宫内窘迫、多胎妊娠、高龄产妇、妊高症及子痫为影响脑性瘫痪的独立产前危险因素,应对这些因素进行干预,加强孕妇产前检查及相关教育,做到早发现、早干预、早治疗,降低脑瘫的患病率。Objective The objective of this study was to analyze the prenatal risk factors and clinical characteristics of cerebral palsy(CP)patients,and to provide a scientific basis for the prevention,early diagnosis and treatment.Methods A total sample of2100patients treated in the functional neurosurgery department of the General Hospital of Chinese People's Armed Police Force between October2012and May2017were selected as the observation group,and2100normal newborn baby matched in age and sex in our hospital obstetrics department were chosen as the control group.The clinical characteristics of CP patients in observation group were retrospectively analyzed,and the differences between these two groups prior to labor were compared.Factors that caused CP were summarized.Results Among the2100patients,1390cases(66.19%)were male and710cases female(33.81%),and their average age was(7.43±6.21)years.The most common type of CP was spastic CP(74.10%).Gross Motor Function Classification System(GMFCS)Ⅱwas common,accounting for40.62%.There were747(35.57%)cases of cesarean section and1353(64.43%)cases of natural birth.Prenatal risk factors analysis showed that the incidence rate of prematurity,endouterine asphyxia,multiple births,advanced maternal age,gestational hypertension and pre-eclampsia in observation group were significantly higher than those of control group and the differences were statistically significant.The multivariate Logistic regression analysis showed that prematurity,endouterine asphyxia,multiple births,advanced maternal age,gestational hypertension or pre-eclampsia were independent risk factors for CP.Conclusions CP is caused by multiple risk factors jointly.Prenatal factors play an important role in the incidence of cerebral palsy,among which prematurity,endouterine asphyxia,multiple births,advanced maternal age,gestational hypertension and pre-eclampsia are the independent prenatal risk factors for CP.It is necessary that these factors should be intervened,prenatal examination and related education be strength

关 键 词：脑性瘫痪 临床特征 产前危险因素 早产 

分 类 号：R741[医药卫生—神经病学与精神病学]