颈总动脉交感神经网剥脱术后脑瘫患儿脑电图及TCD监测指标改变的意义
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摘要
目的探讨颈总动脉交感神经网剥脱术后脑瘫患儿脑电图及TCD监测指标的改变,分析脑功能及脑血流的变化。方法选取脑瘫患儿132例,采用随机数字表法随机分成试验组(66例)和对照组(66例),对照组仅给予常规康复治疗,试验组在常规康复治疗的基础上实施颈总动脉交感神经网剥脱术。在治疗1个月及3个月后,分别测定患儿的脑电图及大脑前动脉(ACA)、大脑中动脉(MCA)和大脑后动脉(PCA)的血流变化。结果两组患儿治疗前脑电图及大脑ACA、MCA、PCA血流的差异均无统计学意义(P>0.05)。试验组患儿治疗1个月及3个月后的脑电图及大脑ACA、MCA、PCA的血流明显优于对照组(P<0.05)。结论实施颈总动脉交感神经网剥脱术,可改善脑瘫患儿的脑功能,增强治疗效果,并提高脑瘫患儿脑内血流,改善其脑部血液循环。
Objective To study the change of electroencephalography(EEG)and transcranial doppler(TCD)monitoring indicators in cerebral palsy children,before and after the cervical perivascular sympathectomy,in order to analysis the change of brain function and cerebral blood flow.Methods 132 cases of cerebral palsy children were equally divided into 2 groups(experimental group and control group)randomly by using the random number table method.The control group was only given routine rehabilitation exercise.The experimental group was carried out cervical perivascular sympathectomy on the basis of routine rehabilitation.Before and after 1and 3 months of the treatment,the brain function and cerebral blood flow were observed by anterior cerebral artery(ACA),middle cerebral artery(MCA),posterior cerebral artery(PCA).Results Before the treatment,the children′s brain function and cerebral ACA,MCA,PCA blood flow showed no significant differences(P >0.05)between two groups.After treatment1 month and 3months,the children's brain function and cerebral blood flow of ACA,MCA,PCA in experimental group were significantly better than that of the control group(P <0.05).Conclusion The cervical perivascular sympathectomy could improve brain function and enhance the treatment effect for cerebral palsy children by enhancing cerebral blood flow and improving brainblood circulation.
Objective To study the change of electroencephalography(EEG)and transcranial doppler(TCD)monitoring indicators in cerebral palsy children,before and after the cervical perivascular sympathectomy,in order to analysis the change of brain function and cerebral blood flow.Methods 132 cases of cerebral palsy children were equally divided into 2 groups(experimental group and control group)randomly by using the random number table method.The control group was only given routine rehabilitation exercise.The experimental group was carried out cervical perivascular sympathectomy on the basis of routine rehabilitation.Before and after 1and 3 months of the treatment,the brain function and cerebral blood flow were observed by anterior cerebral artery(ACA),middle cerebral artery(MCA),posterior cerebral artery(PCA).Results Before the treatment,the children′s brain function and cerebral ACA,MCA,PCA blood flow showed no significant differences(P >0.05)between two groups.After treatment1 month and 3months,the children's brain function and cerebral blood flow of ACA,MCA,PCA in experimental group were significantly better than that of the control group(P <0.05).Conclusion The cervical perivascular sympathectomy could improve brain function and enhance the treatment effect for cerebral palsy children by enhancing cerebral blood flow and improving brainblood circulation.
引文
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[9]李文娟,滕军放.神经电生理监测在神经重症病房中的应用[J].中国实用神经疾病杂志,2014,17(23):147-149.
[10]李雪梅,姜志梅,郭岚敏,等.脑电生物反馈治疗对痉挛型脑瘫患儿脑功能的改善作用[J].中国康复医学杂志,2012,27(2):138-141.
[11]Grandy TH,Werkle-Bergner M,Chicherio C,et al.Peak individual alpha frequency qualifies as a stable neurophysiological trait marker in healthy younger andolder adults[J].Psychophysiology,2013,50(2):570-582.
[12]赵龙莲,伍文清,胡广书.基于脑电反馈的难治性癫痫病人的近似熵分析[J].清华大学学报:自然科学版,2009,49(3):413-417.
[13]Mangoni AA,Mircoli L,Giannattasio C.Effect of sympathectomy on mechanical properties of common carotid and femoral arteries[J].Hypertension,1997,30(5):1085-1088.
[2]秦泗河,葛建忠,陈建文.1090例脑性瘫痪外科手术治疗统计分析[J].中国骨与关节外科,2011,4(5):374-379.
[3]秦泗河.颈总动脉周围交感神经网剥离切除术治疗脑性瘫痪[J].中国康复医学杂志,1996,11(3):100-101.
[4]高晶,王莉娜,赵斌,等.脑性瘫痪患儿母亲分娩方式相关影响因素研究[J].中国全科医学,2013,16(24):2813-2815.
[5]Futaqi Y,Shimizu H,Mimaki T.Internal carotid blood flow velocity in children with cerebral palsy by Doppler Ultrasound method[J].Brain Dev,1982,4(1):27-33.
[6]Wang M,Reid D.Virtual reality in pediatric neurorehabilitation:attention deficit hyperactivity disorder,autism and cerebral palsy[J].Neuroepidemiology,2011,36(1):2-18.
[7]Wartenberg KE,Mayer SA.Multimmodal brain monitoring in the neurological intensive care unit:where does continuous EEG fitin[J].J Clin Neurophysiol,2005,22(2):124-127.
[8]杨亚川,但炜,孙晓川.脑电图在重症脑损伤后脑功能评价的研究进展[J].临床神经外科杂志,2015,12(2):147-149.
[9]李文娟,滕军放.神经电生理监测在神经重症病房中的应用[J].中国实用神经疾病杂志,2014,17(23):147-149.
[10]李雪梅,姜志梅,郭岚敏,等.脑电生物反馈治疗对痉挛型脑瘫患儿脑功能的改善作用[J].中国康复医学杂志,2012,27(2):138-141.
[11]Grandy TH,Werkle-Bergner M,Chicherio C,et al.Peak individual alpha frequency qualifies as a stable neurophysiological trait marker in healthy younger andolder adults[J].Psychophysiology,2013,50(2):570-582.
[12]赵龙莲,伍文清,胡广书.基于脑电反馈的难治性癫痫病人的近似熵分析[J].清华大学学报:自然科学版,2009,49(3):413-417.
[13]Mangoni AA,Mircoli L,Giannattasio C.Effect of sympathectomy on mechanical properties of common carotid and femoral arteries[J].Hypertension,1997,30(5):1085-1088.