偏瘫儿童108例临床特点及精细功能预后分析

Clinical characteristics and prognosis of fine motor function in 108 children with hemiplegia

目的分析偏瘫儿童的临床特点以及精细功能预后的影响因素,为偏瘫儿童科学管理提供参考依据。方法回顾性分析2017年6月—2021年12月在深圳市儿童医院治疗的108例偏瘫儿童的临床资料,并分析偏瘫儿童精细功能预后的影响因素。结果108例偏瘫儿童中,产前及产时因素所导致偏瘫者23例(21.3%),产后损伤85例(78.7%),其中脑外伤33例(30.6%);1~岁组和4~岁组患儿主要由脑外伤因素导致(37.7%,23/61),其次是脑卒中因素(21.3%,13/61);认知障碍负向影响精细运动功能FMFM得分(β=-0.25,P<0.05),诊断年龄正向影响精细运动功能FMFM得分(β=0.449,P<0.001)。结论儿童偏瘫致伤原因中产后获得性因素占比大,脑外伤是主要致伤原因;认知功能障碍及诊断年龄是精细运动功能的影响因素。

Objective To analyze the clinical characteristics and the influencing factors of prognosis of fine motor function in 108 children with hemiplegia,so as to provide reference for scientific management of children with hemiplegia.Methods The clinical data of 108 children with hemiplegia hospitalized in Shenzhen Children's Hospital from June 2017 to December 2021 were retrospectively analyzed,and the influencing factors of prognosis of fine motor function in children with hemiplegia were analyzed.Results Among the 108 children with hemiplegia,there were 23 cases(21.3%)caused by prenatal and perinatal factors,85 cases(78.7%)caused by postpartum injuries,including 33 cases(30.6%)caused by brain trauma.The hemiplegia diagnosed in 1 to 4 years old and 4 to 7 years old was mainly caused by traumatic brain injury(37.7%,23/61),followed by stroke(21.3%,13/61).Cognitive impairment negatively affected Fine Motor Function Measure(FMFM)score(β=-0.25,P<0.05),while diagnosis age positively affected FMFM score(β=0.449,P<0.001).Conclusions Among the causes of hemiplegia injury in children,postpartum acquired factors account for a large proportion,and brain trauma is the main cause.Cognitive dysfunction and age of diagnosis are the influencing factors of fine motor function score.