严重意识障碍患儿废用性骨量丢失的临床研究  

Clinical study of waste bone loss in children with severe disturbance of consciousness

作　　者：冉应权[1] 李邦惠[1] 梅术芳 Ran Yingquan;Li Banghui;Mei Shufang(Department of Rehabiletation,Children’s Hospital of Chongqing Medical University,Chongqing 400014,China)

机构地区：[1]重庆医科大学附属儿童医院康复中心,重庆400014

出　　处：《医药前沿》2020年第14期33-35,共3页Journal of Frontiers of Medicine

摘　　要：目的:分析严重意识障碍患儿双能X线骨密度检查资料,总结其面积骨密度Z值随卧床时间变化的规律,早期干预废用性骨量减低和防止病理性骨折发生。方法:收集2017年1月—2019年1月入住我院康复科的31例严重意识障碍患儿,给予综合康复治疗,在病程1个月、4个月及12个月时采用美国双能X线骨密度仪A S Y-05119检测患儿面积骨密度(a B M D)。骨密度测量部位为腰椎正位(L1-4)和髋部股骨颈。结果:卧床1个月,患儿腰椎a B M D Z值为(-1.11±0.87),卧床时间4个月,腰椎aBMD Z值为(-2.04±0.64),卧床12个月,患儿腰椎aBMD Z值为(-1.52±1.05)。≥5岁严重意识障碍卧床一个月患儿髋部股骨颈aBMD Z值为(-2.06±1.28)g/m2,腰椎正位(L1-4)aBMD Z值(-1.06±0.90)。结论:卧床1个月,骨量减少;卧床4个月,骨量严重下降;卧床12个月积极康复治疗较卧床4个月a B M D有所改善;≥5岁严重意识障碍患儿卧床一个月后髋部股骨颈和腰椎都出现骨量下降,故对≥5岁长期卧床的患儿同时检测腰椎正位(L1-4)和髋部股骨颈B M D是很必要的。Objective We analyzed bone mineral density(BMD)variation by contrasting the BMD Z value of patients with different bedridden duration.We aim to determine the bone metabolism in children with severe consciousness disturbance,and provide treatment and prevetion of pathological gractures.Methods We collected 31 pediatric patients with severe consciousness disturbance from January 2017 to January 2019 that were admitted in our rehabilitation center.All of them were administered comprehensive rehabilitation treatment,and their BMD of the lumbar 1-4 vertebrae and bilateral hips at the same points was measued on dual Energy X-ray Absorptiometry(DEXA)ASY-05119.BMD data was tested at 1,4 and 12 months for all patients,and then the data was processed by SPSS 19 statistical software.Results BMD of the lumbar 1-4 vertebrae at 1 month,4 month and 12 month is(-1.11±0.87),(-2.04±0.64),and(-1.52±1.05),respectively.For patients aged 5 and older who wasbedrided fou one month,their BMD of the lumbar 1-4 vertebrae at 1 month was(-2.06±1.28),while the BMD of the hips at the same points was(-1.06±0.90).Conclusion The BMD decreased dramatically in patients with severe consciousness disturbance,and processed progressively during the beginning of 4 months.It showed a slight rebound of lumbar vertebrae BMD at 12 months.The BMD of the femoral neck of the hip and the lumbar vertebra in the long-term bedridden children with severe consciousness disorder’s bone mass decreased.It suggested that the necessity of combing BMD test of lumbar vertebrae and hips for patients aged 5 and older.

关 键 词：严重意识障碍患儿 骨质密度 卧床时间 康复治疗 

分 类 号：R726[医药卫生—儿科]