小儿肌性斜颈早期治疗

Treatment for children with congenital muscular torticollis

目的提出了小儿肌性斜颈早期手术治疗的一种挑战性做法以防止头面部的偏斜造成不可逆而又无法矫正的并发症。方法对本院287例斜颈手术患儿进行了临床追踪观察,17例4个月以下婴儿皆行胸锁乳突肌肿块切除术,5个月～14岁270例中,术前243例面部及头颅偏斜畸形,占90%。其中210例进行按摩治疗,41例按摩加牵引治疗。结果大多数斜颈患儿手术时多是由于康复治疗效果不佳,并已经出现头面偏斜才进行手术治疗,虽然斜颈得到矫正,但头面偏斜将无法改变。婴儿组17例,随访3月～6年,100%恢复正常功能,且无一例出现面部偏斜。结论新生儿期斜颈早期行肿块切除术,可获最佳的治疗效果。

Objective Advocating to treat congenital muscular torticollis（CMT） with operation in earlier period to prevent facial asymmetry or plagiocephaly during the follow-up period after physical treatment. Methods The data of 287 CMT patients treated in our hospital retrospectively evaluated. 17 patients under 4 months old were performed tylectomy of sternocleidomastoid muscle. Of 270 patients from 5 months to 14 years old,243 patients who had facial asymmetry or plagiocephaly accepted physical treatment （210 accepted cheirapsis simply and 41 accepted traction simultaneously）. Results Most of the patients were operated because of plagiocephaly after invalid physical treatment and the torticollis were corrected but the facial asymmetry could not be recovered. 17 patients under 4 months old who accepted operation were cured completely and no facial asymmetry or plagiocephaly after 3 months to 6 years foiling-up. Conclusion The CMT patients should be performed tyleetomy of sternocleidomastoid muscle in earlier stage to achieve the best therapeutic result.