小儿脑性瘫痪的病例对照研究

A Case control Study on Cerebral Palsy in Children

目的 确定脑瘫的危险因素。方法 １９９７ 年５ ～６ 月在江苏南部进行了以人群为基础的１∶２ 病例对照研究。结果 将脑瘫的危险因素分为４ 类：胎儿发育迟缓、早产和低出生体重；出生窒息、颅内出血、缺血缺氧性脑病及高胆红素脑病；胎头吸引和脑外伤；其他（ 主要是产前因素） 。结论前２ 类因素与脑瘫的关联程度强并且重复性好。应加强产前保健，预防低出生体重等因素的发生；对出生窒息应积极治疗、密切观察；对于第３ 类因素应以产科实践和教育家长为关键措施；对第４ 类因素的认识程度还比较匮乏，可能与第１ 和第２ 类因素密切关联。

Objective To identify the risk factors for cerebral palsy (CP)in children.Methods A population based 1∶2 matched case control study was conducted during May to June 1997 in southern Jiangsu Province of China. Results Risk factors for CP in children could be summarized into four categories,i.e.; ① fetal growth retardation,preterm delivery and low birth weight; ② asphyxia at birth,intracranial hemorrhage,ischemic and hypoxic encephalopathy and hyperbilirubinemic encephalopathy; ③ delivery with vaccum suction and traumatic brain injury;and ④ other prenatal factors. Conclusion The first and second categories of risk factors correlated strongly and reproducibly with CP in children.It is emphasized that antenatal care be enforced to prevent occurrence of risk factors,such as low birth weight,etc.,and the newborns with asphyxia be vigorously rescued and put under close supervision.For risk factors in the third category,the key measures should be obstetric practice and health education for the parents.But,little about the knowledge of the risk factors in the fourth category has been understood,which could be associated with those in the first two categories.