脑性瘫痪致病因素及诊断探讨

Exploration for pathogenic factors and diagnosis of cerebral palsy in children

为探讨脑性瘫痪的致病因素及诊断问题,回顾性分析了50例脑瘫患儿围产期病史,详细的临床评估、影像学及电生理检查,并征询家长对康复治疗意见。结果显示脑瘫以早产、低出生体重、围产期窒息为主要致病因素;脑瘫以痉挛性类型为主,尤以四肢瘫为多且重;脑瘫合并语言发育障碍44％,智力迟缓32％,听力异常18％,视力异常16％。癫癎16％;CT或MRI检查68％异常;接受运动、针灸、作业及语言治疗的依从性分别为86％、68％、46％、100％。提示建立多科联合对高危新生儿的监护和随访甚为重要;全面熟悉小儿发育知识、神经反射及Vojta姿式反射,增强康复观念,有助于脑瘫的早期诊断和干预;此外,还应加强全面康复的科普宣传。

To explore the pathogenic factors and diagnosis of cerebral palsy (CP) in children, perinatal history, clinical evaluation, imaging and electrophysiological data and parents' attitude for rehabilitation of CP were analyzed and investigated in 50 children with CP retrospectively. The results showed that premature birth, low birth weight and perinatal asphyxia were the most pathogenic factors induced CP. The common CP types was spastic paralysis, in particular quadriparesis. Abnormal CT and MRI findings were detected in 68% of CP children. It was noticed that 44% of CP children were with speech and language disorder, 32% with mental retardation, 18% with hearing impairment, 16% with visual impairment and 16% with epilepsy. There were 86% parents to accept with physiotherapy on their CP children, 68% with acupuncture therapy, 46% with occupational therapy and 100% with speech therapy, respectively. It is suggested that multi-subject cooperation will be necessary for the follow-up study of the high-risk infants. The realization of the related-speciality knowledge and the enhancement of rehabilitational conception will be helpful for the early diagnosis and intervention of CP patients. The popularization of rehabilitational conception will be also important in the parents with CP children.