两种方法治疗婴儿姿势性斜头畸形的临床效果比较  

Comparison of clinical effects between two methods for treating positional plagiocephaly in infants

作　　者：吴晓燕 尚美辰 刘华 戴娜 朱红静 杨明[1] Wu Xiaoyan;Shang Meichen;Liu Hua;Dai Na;Zhu Hongjing;Yang Ming(Department of Pediatric,Beijing United Family Hospital,Beijing 100015,China)

机构地区：[1]北京和睦家医院儿科,北京100015

出　　处：《发育医学电子杂志》2025年第2期103-108,共6页Journal of Developmental Medicine (Electronic Version)

摘　　要：目的探讨体位调整效果欠佳者序贯头型矫正器(cranial remolding orthoses,CRO)治疗及单纯CRO治疗在婴儿姿势性斜头畸形(positional plagiocephaly,PP)治疗中的临床效果,以优化治疗策略。方法采用回顾性研究纳入2019年2月至2024年2月北京和睦家医院儿科头型矫正门诊治疗的85例3~7月龄PP婴儿。按照自愿原则选择治疗方法,56例为体位调整组,其中24例体位调整无效的婴儿中18例体位调整效果欠佳接受CRO治疗;29例首选CRO治疗。通过三维激光获取技术测量头颅不对称度(cranial vault asymmetry,CVA)、头颅不对称指数(cranial vault asymmetry index,CVAI)、前部对称比(anterior symmetry ratio,ASR)及后部对称比(posterior symmetry ratio,PSR)。以CVAI改善率作为评估斜头畸形治疗效果的参考数据。CVAI改善率≥10%定义为治疗干预有效。比较两种治疗方案的临床效果。统计学方法采用t检验和Mann-Whitney U检验。结果体位调整治疗组有效率为57.1%(32/56),CVAI改善率为[19.0(1.6,37.9)]%。18例接受了序贯CRO治疗,有效率为100%(18/18),CVAI改善率为[51.5(38.0,68.4)]%,序贯CRO治疗后CVAI低于治疗前[(3.0±1.3)%与(7.0±2.3)%,t=6.248,P<0.001];单纯CRO治疗组有效率为100%(29/29),CVAI改善率为[53.7(33.4,67.3)]%,与序贯CRO治疗差异无统计学意义(Z=-0.120,P>0.05),单纯CRO治疗后CVAI低于治疗前[((7.5±2.3)%与(3.5±1.7)%,t=7.191,P<0.001)]。序贯治疗时间长于单纯CRO治疗[((5.7±2.2)个月与(3.4±1.5)个月,t=4.288,P<0.001)]。序贯治疗佩戴CRO的时间长于单纯CRO治疗[((4.4±1.8)个月与(3.4±1.5)个月,t=2.129,P<0.05)]。两组间治疗前后斜头畸形的严重程度及治疗效果差异均无统计学意义(P值均>0.05)。结论对于3~7月龄PP婴儿,体位调整可以让50%以上婴儿头型得到有效的改善,但其治疗效果不及CRO治疗。如果体位调整效果欠佳采用序贯CRO治疗,与单纯CRO治疗效果相似,但是单纯CRO治疗时间短于序贯治疗。Objective To explore the clinical effects of positional adjustment unsatisfied sequential cranial remolding orthoses(CRO)and CRO alone treatment in the treatment of infant positional plagiocephaly(PP),in order to optimize treatment strategies.Method A total of 85 infants with PP aged 3 to 7 months treated at the Pediatric Head Correction Clinic of Beijing United Family Hospital from February 2019 to February 2024 were included in the retrospective study.According to the principle of voluntary selection of treatment methods,56 cases were in the postural adjustment group,of which 18 out of 24 infants with ineffective postural adjustment received CRO treatment;CRO treatment was preferred in 29 cases.Measurement of cranial vault asymmetry(CVA),cranial vault asymmetry index(CVAI),anterior symmetry ratio(ASR),and posterior symmetry ratio(PSR)using three-dimensional laser acquisition technology.The improvement rate of CVAI was used as reference data to evaluate the treatment effect of PP.CVAI improvement rate≥10%was defined as effective treatment intervention.Compare the clinical outcomes of two treatment options.Statistical methods performed by t-test,Mann-Whitney U test.Result The effectiveness rate of the positional adjustment treatment group was 57.1%(32/56),with a CVAI improvement rate of[19.0(1.6,37.9)]%.Among them,18 patients received sequential CRO treatment,achieving an effectiveness rate of 100%(18/18)and a CVAI improvement rate of[51.5(38.0,68.4)]%.The CVAI after sequential CRO treatment was significantly lower than before treatment[(3.0±1.3)%vs(7.0±2.3)%,t=6.248,P<0.001].The effectiveness rate of the pure CRO treatment group was 100%(29/29),with a CVAI improvement rate of[53.7(33.4,67.3)]%,showing no statistically significant difference compared to the sequential CRO treatment group(Z=-0.120,P>0.05).The CVAI after pure CRO treatment was significantly lower than before treatment[(7.5±2.3)%vs(3.5±1.7)%,t=7.191,P<0.001].The duration of sequential treatment was longer than that of pure CRO treatment[(5.7±

关 键 词：姿势性斜头畸形 体位调整 头型矫正器 头颅不对称指数 前部对称比 后部对称比 

分 类 号：R47[医药卫生—护理学]