伴神经元移行异常脑性瘫痪儿童的临床特征及疗效分析

发布时间：2018-11-13 11:10

【摘要】：目的回顾性分析伴神经元移行异常(NMD)脑瘫的临床特点及疗效。方法选取2005年6月至2015年6月在本科进行综合康复治疗的伴NMD脑瘫患儿(NMD组,n=32)和同期康复治疗的运动、智力水平近似的伴有脑室周围白质软化症(PVL)脑瘫患儿(PVL组,n=60)。分析比较两组脑瘫临床分型、癫痫及癫痫样放电共患病以及综合康复治疗对两组患儿粗大运动功能测试(GMFM)评分和Gesell发育诊断量表发育商(DQ)的影响。同时,对治疗6个月后的随访结果进行统计分析。结果两组脑瘫临床分型存在非常高度显著性差异(χ2=24.529,P0.001)。NMD组癫痫及癫痫样放电共患病发生率均高于PVL组(χ24.605,P0.05)。综合康复治疗后,两组GMFM评分随时间均升高(F时间=6.850,P=0.010),NMD组GMFM评分显著低于PVL组(F组间=29.885,P0.001);各功能区DQ得分随时间逐渐增高(F时间25.041,P0.001),NMD组各功能区DQ得分显著低于PVL组(F组间32.347,P0.001)。结论伴NMD脑瘫癫痫伴发率高,临床表现以智力发育障碍和痉挛型偏瘫为主,综合康复治疗疗效差,预后不良。
[Abstract]:Objective to retrospectively analyze the clinical characteristics and curative effect of (NMD) cerebral palsy with neuronal transition abnormality. Methods from June 2005 to June 2015, children with NMD cerebral palsy (NMD group, nong32) and children with (PVL) cerebral palsy with periventricular leukomalacia (PVL group) who received comprehensive rehabilitation therapy from June 2005 to June 2015 were selected. 60) The clinical classification of cerebral palsy, epilepsy and epileptiform discharge co-prevalence and comprehensive rehabilitation therapy were analyzed and compared in the two groups on the (GMFM) score of gross motor function test and the development quotient (DQ) of Gesell development diagnostic scale. At the same time, the follow-up results after 6 months of treatment were statistically analyzed. Results there was a very significant difference in the clinical classification of cerebral palsy between the two groups (蠂 2 + 24.529 + P0.001). The incidence of epilepsy and epileptoid discharge co-infection in the). NMD group was higher than that in the PVL group (蠂 24.605 P 0.05). After comprehensive rehabilitation treatment, the GMFM score of both groups increased with time (F time = 6.850), NMD, GMFM score was significantly lower than that in PVL group (F group = 29.885p 0.001). The DQ score of each functional area increased gradually with time (F time 25.041 卤P0.001). The DQ score of each functional area in), NMD group was significantly lower than that in PVL group (32.347 卤P0.001 between F group). Conclusion the incidence rate of epilepsy associated with NMD cerebral palsy is high. The main clinical manifestations are mental retardation and spastic hemiplegia. The comprehensive rehabilitation treatment has poor curative effect and poor prognosis.
【作者单位】：广州中医药大学附属南海妇产儿童医院儿童神经康复科;
【分类号】：R742.3

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