磁共振成像用于脑性瘫痪患儿康复训练及电刺激治疗干预后的效果评估

Value of MRI in assessing the effects of rehabilitation training and electrical stimulation intervention in children with cerebral palsy

目的:研究磁共振成像(MRI)用于脑性瘫痪患儿康复训练及电刺激治疗干预后的效果。方法:选取在医院接受治疗的80例脑性瘫痪患儿,按照随机数表法将其分为联合干预组和对照组,每组40例。对照组在常规康复训练基础上进行脑电仿生电刺激治疗,联合干预组在对照组常规康复训练基础上行脑电仿生电刺激治疗联合感觉统合训练,比较两组训练治疗后的临床疗效,训练治疗前后盖泽尔发展诊断量表(GDS)评分及MRI征象,以及两组训练治疗后的不良反应发生率。结果:联合干预组训练治疗总有效率为90.00%,显著高于对照组(72.50%),其差异有统计学意义(χ^(2)=4.021,P<0.05)。两组神经系统完善和功能情况比较,训练治疗后适应性行为、粗大运动、精细运动、语言及个人-社会行为评分均显著高于训练治疗前,且联合干预组训练治疗后适应性行为、粗大运动、精细运动、语言及个人-社会行为评分高于对照组,其差异有统计学意义(t=3.015,t=4.407,t=2.961,t=2.409,t=3.471;P<0.05)。联合干预组训练治疗后MRI征象变化情况比较,室旁白质软化、脑发育不良及基底节丘脑异常信号发生率显著低于训练治疗前及对照组,联合干预组训练治疗后室旁白质软化、基底节丘脑异常信号发生率均低于对照组,其差异有统计学意义(χ^(2)=4.266,χ^(2)=4.381;P<0.05)。联合干预组训练治疗后不良反应总发生率为22.50%,与对照组的15.00%比较差异无统计学意义。结论:通过改善MRI征象较好地实现了感觉统合训练配合脑电仿生电刺激治疗脑性瘫痪患儿的治疗效果,给临床治疗提供了依据。

Objective:To study the value of magnetic resonance imaging(MRI)in assessing the effects of rehabilitation training and electrical stimulation intervention in children with cerebral palsy.Methods:A total of 80 children with cerebral palsy who were treated in hospital were selected as the research objects,and they were randomly divided into the combination group and the control group according to the random number table method,with 40 cases in each group.The control group received electroencephalograph(EEG)bionic electrical stimulation on the basis of routine rehabilitation training,and the combination group received EEG bionic electrical stimulation combined with sensory integration training on the basis of routine rehabilitation training.The clinical efficacy of the two groups were compared after treatment,and the score of Gajser Development Diagnostic Scale(GDS)and MRI signs before and after training treatment were compared,and the incidences of adverse reactions after treatment between the two groups also was compared.Results:The total effective rate of the combined group was 90.00%,which was significantly higher than that of the control group(72.50%),and the difference of that between two groups was statistically significant(χ^(2)=4.021,P<0.05).In the comparisons of improvement and function of nervous system of two groups,the scores of adaptive behavior,gross motor,fine motor,language and individual-social behavior both the two groups after training treatment were significantly higher than those before training treatment,and the scores of these indicators after training treatment in the combination group were significantly higher than those in the control group,the differences of them between two groups were statistically significant(t=3.015,t=4.407,t=2.961,t=2.409,t=3.471,P<0.05),respectively.In the comparison of the change of MRI signs,the periventricular leukomalacia(PVL),brain dysplasia and abnormal signals in basal ganglia thalamus after treatment in combined group were significantly lower than those before treatment in combined group,and were significantly lower than those of control group,respectively.After training treatment,the PVL and the incidence of abnormal signals in basal ganglia thalamus of combination group were significantly lower than those of control group,with statistical significance(χ^(2)=4.266,χ^(2)=4.381,P<0.05),respectively.The total incidence of adverse reactions after training treatment in the combination group was 22.50%,which was not significantly different with 15.00%in the control group.Conclusion:EEG bionic electrical stimulation combined with sensory integration training can better realize the curative effect for children with cerebral palsy through improves the MRI signs,which has provided reference for clinical treatment.