成都地区脑性瘫痪患儿422例伴发小头畸形临床分析
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摘要
目的分析伴小头畸形脑性瘫痪(脑瘫)患儿的临床特征,为合理康复管理提供依据。方法总结2013年2月至4月对成都市辖区残联登记为脑性瘫痪的0～18岁儿童进行了横断面调查结果,共计422例。根据头围对患儿进行分组,分析脑瘫患儿头围与粗大运动功能损伤程度(GMFCS)、智力、合并症等相关性。结果两组不同程度头围组与GMFCS分级的分布情况差异有统计学意义(P=0.001)、两组不同程度头围组与认知分级分布情况差异有统计学意义(P<0.001),Spearman相关分析示伴小头畸形脑瘫患儿的伴发障碍数量、GMFCS和认知损伤程度与头围呈负相关(P<0.001)。结论伴小头畸形的脑瘫患儿头围减小程度与GMFCS、伴发障碍的数量和认知损伤程度呈负相关。
Objective(CP);to provide evidence for rehabilitation management. Methods To summarize the results of a cross-sectional survey of a total of 422 children(0-18 years old)who were registered as cerebral palsy by Disabled Persons' Federation of Chengdu from February to April in 2013. All children were grouped according to head circumference. We analyzed the correlation between head circumference with gross motor function classification system(GMFCS),intelligence and complications. Results There were statistically significant between the two different degrees of head circumference group and the classification of GMFCS and cognition respectively(P<0.001). Spearman correlation analysis showed that the number of comorbidities,GMFCS and degree of cognitive damage in children with cerebral palsy with microcephaly were negatively correlated with head circumference(P<0.001). Conclusion The degree of head circumference reduction in children with cerebral palsy complicated by microcephaly is negatively correlated with GMFCS,the number of comorbidities and the degree of cognitive impairment.
Objective(CP);to provide evidence for rehabilitation management. Methods To summarize the results of a cross-sectional survey of a total of 422 children(0-18 years old)who were registered as cerebral palsy by Disabled Persons' Federation of Chengdu from February to April in 2013. All children were grouped according to head circumference. We analyzed the correlation between head circumference with gross motor function classification system(GMFCS),intelligence and complications. Results There were statistically significant between the two different degrees of head circumference group and the classification of GMFCS and cognition respectively(P<0.001). Spearman correlation analysis showed that the number of comorbidities,GMFCS and degree of cognitive damage in children with cerebral palsy with microcephaly were negatively correlated with head circumference(P<0.001). Conclusion The degree of head circumference reduction in children with cerebral palsy complicated by microcephaly is negatively correlated with GMFCS,the number of comorbidities and the degree of cognitive impairment.
引文
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[12]段军,芮芳,唐久来,等.脑性瘫痪儿童临床分型与合并症的相关性分析[J].安徽医学,2011,32(1):5-8.
[13]彭桂兰,蔡淑英,黄种钦,等.厦门地区小儿脑瘫临床分型、早期症状及合并症调查分析[J].中国优生与遗传杂志,2016,2016(7):128-129.
[14]Coronado R,Macaya RA,Giraldo AJ,et al.Concordance between a head circumference growth function and intellectual disability in relation with the cause of microcephaly[J].An Pediatr(Barc),2015,83(2):109-116.
[15]中华医学会儿科学分会康复学组.2017年JAMA Pediatrics《脑性瘫痪早期精准诊断与早期干预治疗进展》中国专家解读[J].中国实用儿科杂志,2018,33(10):743-749.
[16]宋为群,胡洁.儿童诊知障碍促神经调控治疗[J].中国实用儿科杂志,2017,32(4):294-296.
[17]吕远,刘彩霞.遗传性疾病史女性孕前咨询要点[J].中国实用妇科与产科杂志,2018,34(12):1348-1352.
[18]王小兰,罗华英,黎瑞春,等.多学科早期干预对早产儿体格发育和智力影响的研究[J].中国实用妇科与产科杂志,2016,32(2):188-191.
[19]冯玲,余俊.加强孕前保健,改善母儿结局[J].中国实用妇科与产科杂志,2018,34(12):1315-1317.
[2]徐玲,杨亚丽,王纪文,等.小儿脑性瘫痪的流行病学研究进展[J].中华物理医学与康复杂志,2013,35(3):227-228.
[3]王芳芳,罗蓉,母得志.小头畸形的临床诊断与细胞和分子生物学诊断的研究进展[J].中华妇幼临床医学杂志(电子版),2016,12(3):369-372.
[4]王秋,罗蓉,石娅娅,等.成都地区脑瘫儿童粗大运动功能分级与脑瘫高危因素的相关性分析[J].四川大学学报(医学版),2016,47(5):772-776.
[5]Woods CG,Parker A.Investigating microcephaly[J].Arch Dis Child,2013,98(9):707-713.
[6]Harris SR.Measuring head circumference:update on infant microcephaly[J].Can Fam Physician,2015,61(8):680-684.
[7]马丹,王秋,李娜,等.粗大运动功能分级系统在脑性瘫痪中的应用研究进展[J].中国儿童保健杂志,2015,23(6):607-609.
[8]孙殿荣,侯梅,李君,等.学龄前脑性瘫痪患儿智力水平调查[J].中国康复理论与实践,2013,19(9):874-877.
[9]Piro E,Antona V,Consiglio V,et al.Microcephaly a clinicalgenetic and neurologic approach[J].Acta Medica Mediterranea,2013,29(2):327-331
[10]Minciu I.Clinical correlations in cerebral palsy[J].Medica,2012,7(4):319-324.
[11]Rankin J,Cans C,Garne E,et al.Congenital anomalies in children with cerebral palsy:a population-based record linkage study[J].Dev Med Child Neurol,2010,52(4):345-351.
[12]段军,芮芳,唐久来,等.脑性瘫痪儿童临床分型与合并症的相关性分析[J].安徽医学,2011,32(1):5-8.
[13]彭桂兰,蔡淑英,黄种钦,等.厦门地区小儿脑瘫临床分型、早期症状及合并症调查分析[J].中国优生与遗传杂志,2016,2016(7):128-129.
[14]Coronado R,Macaya RA,Giraldo AJ,et al.Concordance between a head circumference growth function and intellectual disability in relation with the cause of microcephaly[J].An Pediatr(Barc),2015,83(2):109-116.
[15]中华医学会儿科学分会康复学组.2017年JAMA Pediatrics《脑性瘫痪早期精准诊断与早期干预治疗进展》中国专家解读[J].中国实用儿科杂志,2018,33(10):743-749.
[16]宋为群,胡洁.儿童诊知障碍促神经调控治疗[J].中国实用儿科杂志,2017,32(4):294-296.
[17]吕远,刘彩霞.遗传性疾病史女性孕前咨询要点[J].中国实用妇科与产科杂志,2018,34(12):1348-1352.
[18]王小兰,罗华英,黎瑞春,等.多学科早期干预对早产儿体格发育和智力影响的研究[J].中国实用妇科与产科杂志,2016,32(2):188-191.
[19]冯玲,余俊.加强孕前保健,改善母儿结局[J].中国实用妇科与产科杂志,2018,34(12):1315-1317.