小儿脑性瘫痪独立步行功能获得的早期预测

Early prediction on independent walking in cerebral palsy(CP) children

目的：通过运动功能、姿势反应和原始反射来探讨预测脑瘫患儿独立步行的可能性。方法：对９０例４个月～５岁的脑瘫患儿作治疗前、治疗后及随访中主要运动功能获得、部分原始反射残存及降落伞反应建立时间进行动态观察，并以同期６２０例正常儿童为对照。结果：痉挛性脑瘫疗效较好，多数以后能独立行走（Ｐ＜０．０１）；１８个月前能翻身、２４个月前能坐、３０个月前能膝爬是脑瘫患儿以后能独立步行的非常有价值的早期预测指标。其他包括生后１２个月前ＡＴＮＲ、ＳＴＮＲ、ＴＬＲ、ＭＯＲＯ等部分原始反射消失，２４个月前降落伞反应建立。结论：脑瘫患儿的主要运动功能获得、姿势反应建立及原始反射消失时间是预测以后能否独立步行的极有价值的观察指标。

Objective:The paper was to study the possibility of early prediction on independent walking in CP children by motor function,postural reflex and primitive reflex.Methods:90 CP children at the age of 4 months to 5 years were dynamically observed the main motor function,part surviving primitive reflex and establishing parachute response before and after treatment or follow-up period.620 normal children as a control group were compared.Results:It showed that curative effects in spastic CP children were better than the other CP children,and most CP children were obtained an ability of independent walking later(P<0.01).If the CP children can turn-over in bed,sit in chair and crawl before 18 months,24 months and 30 months respectively;the early prediction of independent walking is possible.In addition,other indexes were,including the part primitive reflex(ATNR,STNR,TLR,MORO),disappeared at 12 months after birth,or parachute response established at 24 months after birth.Conclusion:It is demonstrated that these indexes as mentioned above are the good predicting parameters for early prediction on independent walking in CP children.