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目的:探讨围产期脑损伤因素对脑瘫患儿康复疗效及预后的影响。方法:176例脑瘫患儿,其中女48例,男128例。按年龄分为8个月~2岁、2~4岁和4~5岁3组,各年龄组采用方法均为物理疗法、针灸治疗、穴位注射、营养脑神经药物等综合康复治疗。治疗后评估各项结果,按照等级分别为显效、有效和无效。应用Gesell发育量表与粗大运动功能评估(GMFM)对各组患儿进行临床评定。结果:2~4岁组疗效明显优于8个月~2岁和4~5岁组(P<0.05);4~5岁组疗效最低(P<0.05)。新生儿颅内出血+HIE组和足月出生组疗效较为明显,早产患儿在4岁前的治疗效果明显高于4岁后的治疗效果。结论:小儿脑性瘫痪的康复治疗效果可能与年龄有关,年龄越小的患儿治疗效果越好,脑瘫的康复治疗疗效可能还与围产期的高危因素有关,其中早产儿的治疗效果最不明显。
Objective: To investigate the impact of perinatal brain injury on rehabilitation and prognosis of children with cerebral palsy. Methods: 176 children with cerebral palsy, including 48 females, 128 males. They were divided into 3 groups of 8 months to 2 years old, 2 to 4 years old and 4 to 5 years old according to their age. The methods of physical therapy, acupuncture and moxibustion, acupoint injection and nutritional cranial nerve drugs were adopted in all age groups. Post-treatment evaluation of the results, respectively, according to the level of effective, effective and ineffective. Gesell development scale and gross motor function assessment (GMFM) were used to evaluate the clinical features of each group. Results: The curative effect in 2 ~ 4 years old group was better than that in 8 months ~ 2 years old and 4 ~ 5 years old group (P <0.05). The curative effect was the lowest in 4 ~ 5 years old group (P <0.05). Neonatal intracranial hemorrhage + HIE group and full-term birth group more obvious effect, premature children in children before 4 years of treatment was significantly higher than after 4 years of treatment. Conclusion: The effect of rehabilitation treatment on children with cerebral palsy may be related to the age. The younger the children, the better the treatment effect. The rehabilitation effect of cerebral palsy may be related to perinatal high risk factors, of which the treatment effect of premature children is the least obvious.