电刺激小脑并神经发育疗法超早期干预中枢性协调障碍的临床研究

Clinical research of very early intervention with cerebellar electric stimulation and neurodevelopmental treatment on infants of central coordination disturbance

目的观察电刺激小脑顶核并神经发育疗法超早期对中枢性协调障碍患儿(central coordination disturbance,CCD)的疗效。方法对86例CCD患儿(年龄0-<6月)随机分为超早期治疗组:45例;超早期对照组:41例;治疗组采用电刺激小脑顶核、神经发育疗法及家庭干预措施治疗;对照组:采用神经发育疗法及家庭干预措施;所有病例在干预前及干预3月后用上海-Ge-sell发育量表及GMFM量表对运动功能及发育商进行评估。结果超早期治疗组总有效率为95.6%,与对照组(80.0%)比较有显著差异(χ2=4.73,P<0.01);治疗组在动作能、应物能及应人能三个能区的发育商进步分数分别为9.25±1.85、7.9±2.01、7.41±1.45,均显著高于超早期对照组(7.15±1.54;6.12±1.47;6.13±1.54。P<0.05,0.05,0.05)。结论对CCD患儿超早期实施电刺激小脑顶核并神经发育疗法可有效促进其动作、应人、应物的发展,值得临床推广。

Objective To observe the therapeutic effect of very early intervention with cerebellar fastigial nucleus electrical stim- ulation and neurodevelopmental treatment on infants of central coordination disturbance （CCD）. Methods 86 infants （0-6 months） with central coordination disturbance were divided into intervention group and control group. Intervention group was treated with neurodevelopmental treatment, cerebellar fastigialnucleus （FN） electrical stimulation and family interference. The control group was treated with neurodevelopmental treatment and family interference. The motor function and development quotient were assessed with Gesell and GMFM developmental scale. Results The total effective rate of intervention group was significant higher than that of control group （95.60% vs 80.00%, X2 = 4. 73, P〈0.01）. The difference in scores of three functional areas （social area, adaptive area and motor area） in intervention group were significant higher than those of control group （9.25± 1.85 vs 7. 15± 1. 54; 7. 90±2.01 vs 6. 12±1.47;7. 41±1.45 vs 6.13±1.54, respectively,all P^0.05）. Conclusion Very early intervention with cerebellar electric stimulation and neurodevelopmental treatment can facilitate the development of gross motor, social capacity and adaptive capacity on infants of CCD.