425例中枢性协调障碍高危因素与临床分析

High risk factor of 425 patients with zentral coordination disturbance and its clinical analysis

目的 :探讨中枢性协调障碍患儿的病因及早期表现 ,以期在异常姿势及运动障碍尚未出现或固定之前 ,能及早发现神经系统的损害 ,并早期干预、康复治疗患儿。方法 :对 4 2 5例中枢性协调障碍患儿进行运动发育、反射发育、 Vojta姿势反射发育及肌张力等方面的检查 ,结合母亲妊娠期及患儿新生儿期疾病情况进行分析。结果 :本组患儿主要病因依次为母亲妊娠早期感冒 2 8.5 %、早产 2 0 .7%、妊娠早期阴道流血 2 0 .5 %、病理性黄疸 18.8%、羊水浊 16 .7%、脐带因素 14 .8%、宫内窘迫 10 .6 %等。最能引起家人注意的表现主要是易惊跳 4 0 %、睡眠少 32 .2 %、昼夜哭闹不安 2 0 .9%等。体检除 Vojta姿势反射异常外 ,尚有原始反射消退延迟 37.4 % ,踝阵挛阳性 10 .1% ,单侧巴彬斯基征阳性 12 .6 %。结论 :对中枢性协调障碍患儿应引起足够重视 ,通过病因、早期表现及神经发育学检查 ,可以早期发现脑损伤 ,从而阻断因脑损伤所致的各种功能障碍 。

Objective: To explore the cause and early manifestation of patients with central coordination disturbance for discover the damage of nervous system earlier before the occurrence or fixation of abnormal posture and motor disturbance. Then give early intervention and rehabilitation to treat the patients. Methods: To examine 425 patients in development of motor, reflex, Vojta posture reflex and muscular tone. Then to analysis together with the disease involved in the mothers' pregnant stage and the children's neonatal period. Results: The major causes of these patients in turn are cold in the early pregnant stage(28.5%), premature(20.7%), colporrhagia in the early pregnant stage(20.5%), pathological jaundice(18.8%), amniotic fluid cloudy(16.7%), umbilical factor(14.8%), intrauterine asphyxia(10.6%), etc. The main manifestation noticed easiest is pavor(40%), dyssomnia(32.2%),blubber and unrest day and night(20.9%), etc. Physical examination may discover the delay of extinction of primary reflex(37.4%), positive of ankle clonus(10.1%), positive of unilateral Babinski's sign(12.6%), except the abnormal Vojta posture reflex. Conclusion: More attention should be paid to the patients with central coordination disturbance. The damage of brain can be discovered earlier through the causes, early manifestations and examination of nervous development to hold up the various dysfunction caused by brain injury and make the patient's various function develop toward the normal way.