140例脑性瘫痪儿童高危因素及治疗效果分析

An analysis of risk factors of cerebral palsy in 140 children and observation of their therapeutic effects

目的 通过对脑瘫患儿高危因素及治疗效果的分析,寻找预防和治疗小儿脑瘫病的最佳方案,为进一步防治小儿脑瘫提供循证依据.方法 收集2008年6月～2009年12月西安市儿童医院收治的脑瘫患儿病例进行总结分析.结果 脑瘫可能的致病因素较多,其中早产儿占41.43%,缺氧窒息占33.57%,核黄疸、高龄产妇、妊娠期高血压疾病等因素较少,均在5.00%以下;早产儿中胎龄〈34周的低体重早产儿和重度缺氧窒息儿治疗效果差（t值分别为2.34、2.73,均P〉0.01）,早产儿胎龄〉34周且体重〉2kg、轻度缺氧窒息的治疗效果好（t值分别为6.39、14.20,均P〈0.01）;随着康复治疗时间的延长治疗效果有所变化.结论 早产和缺氧窒息可能是小儿脑瘫病的主要致病因素;脑瘫患儿在康复治疗早期,显效率较高,随着康复治疗时间的延长,有效率有所增加;而重度窒息和核黄疸治疗效果较差.随着康复治疗时间的延长,胎龄〈34周且体重〈2kg的早产儿治疗效果有所提高.

Objective To analyze risk factors of cerebral palsy and therapeutic effects of children with cerebral palsy so as to provide evident basis for seeking the best prevention and treatment program for the disease. Methods Medical records of all children who suffered from cerebral palsy and admitted to Xi＇an Municipal Children＇s Hospital in a period from June, 2008 to December, 2009 were analyzed retrospectively. Results Many pathogenic factors may lead to cerebral palsy. Among studied cases, premature infants （41.43%）, anoxic asphyxia（33.57% ）, nuclear jaundice, elderly puerpera, pregnancy-induced hypertension （accounting for less than 5%, respectively）all were causes of cerebral palsy. The therapeutic effects for low birth weight premature infants（ with less than 34 weeks of gestational age） and those with severe anoxic asphyxia were poor （ t = 2.34, 2.73 respectively, beth P 〉 0.01 ）, while the therapeutic effects for those infants with more than 34 weeks of gestational age, birth weight 〉2kg and those with mild anoxic asphyxia were relatively better （t =6.39, 14.20 respectively, both P 〈 0.01 ）. Therapeutic effects varied with prolongation of rehabilitation time. Conclusion Premature labor and anoxic asphyxia may be main pathogenic factors of cerebral palsy in infants. Infants withcerebral palsy may have comparatively higher effective rate in early stage of rehabilitation treatment. Moreover, the effective rate is increased when rehabilitation treatment is continued. Children with severe asphyxia and nuclear jaundice have poor therapeutic effect. Premature infants with less than 34 weeks of gestation and birth weight less than 2kg have better therapeutic effects with lasting of rehabilitation treatment.