颈总动脉周围交感神经网剥脱切除术治疗脑性瘫痪患儿的疗效

The Effect of Exfoliation Excision of Peripheral Sympathetic Nerve Network in Common Carotid Artery in Children with Cerebral Palsy

目的:观察脑性瘫痪患儿行颈总动脉周围交感神经网剥脱切除术治疗后流涎症状、吞咽障碍及认知功能变化。方法:回顾性分析我院2015年10月至2017年5月经不同方式治疗的74例脑性瘫痪患儿的临床资料,并将进行康复治疗的患儿37例,作为对照组,将进行颈总动脉周围交感神经网剥脱切除术治疗的患儿37例,作为观察组。对比两组患者治疗前后大脑中动脉血流动力学指标变化情况及流涎症状、吞咽障碍、认知功能改善情况。结果:治疗后,观察组大脑中动脉各血流动力学指标均优于对照组(P<0.05);观察组教师流涎分级法(TDS)评分、洼田饮水试验评分均较对照组低(P<0.05);观察组韦氏幼儿智力量表(WPPSI)评分较对照组高(P<0.05)。结论:脑性瘫痪患儿应用颈总动脉周围交感神经网剥脱切除术治疗,可对流涎、吞咽功能起到显著改善作用,同时可有效促进认知功能恢复。

Objective： To observe the changes of ptyalism,dysphagia and cognitive function in children with cerebral palsy after the exfoliation excision of the sympathetic nerve network around the common carotid artery. Methods： The clinical data of 74 children with cerebral palsy treated by different ways in our hospital from October 2015 to May 2017 were retrospectively analyzed. The 37 children who were treated by rehabilitation were taken as the control group. The sympathetic surroundings of common carotid artery Nerve net stripping resection of children treated 37 cases as the observation group. The changes of arterial hemodynamics indexes of cerebral artery,and the improvement of ptyalism,dysphagia and cognitive function in the two groups were compared. Results： After treatment,the hemodynamic indexes of the cerebral artery in the observation group were superior to those in the control group（ P〈0.05）; the Teacher Drooling Scale（ TDS） score and the water swallow test score in the observation group were lower than those in the control group（ P〈0. 05）; the score of Wechsler Preschool and Primary Scale of Intelligence（ WPPSI） in the observation group was higher than that in the control group（ P〈0.05）. Conclusion： The application of exfoliation excision of the sympathetic nerve network around the common carotid artery in the treatment of children with cerebral palsy can significantly improve ptyalism and swallowing function,and can effectively promote the recovery of cognitive function.