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目的探讨脐血干细胞移植治疗重症脑瘫的疗效。方法对30名重症脑瘫患儿进行静脉及腰椎穿刺下脐血干细胞移植治疗。治疗方案:使用脐血干细胞注射的方法,细胞数量为(2×107~3×107)个/份。其中第1次为静脉注射,剩余各次均为经腰椎穿刺注射,分别于治疗前后进行安全性指标检测及脑瘫综合功能评定表、粗大运动功能测试量表(gross motor function measure,GMFM)评分。结果统计结果表明,患儿治疗前后安全性指标差异无统计学意义(P>0.05),治疗前后脑瘫综合功能评定表评分及GMFM评分对比均差异有统计学意义(P<0.05),进一步分析发现,脑瘫综合功能评定表的疗效评定总有效率为73.3%,各功能区得分的前后比较中,以运动功能及言语功能的改善最为明显(P<0.05),而GMFM评分的各功能区的前后比较中,仰卧、俯卧及坐位功能的改善有统计学意义(P<0.05)。结论脐血干细胞对于治疗重症脑瘫是安全的,且有一定疗效,特别是在运动功能及言语功能的改善有较好的作用,其中粗大运动功能中以仰卧、俯卧及坐位功能的改善明显。
Objective To investigate the efficacy of cord blood stem cell transplantation in the treatment of severe cerebral palsy. Methods Thirty children with severe cerebral palsy were treated with intravenous and lumbar puncture under umbilical cord blood stem cell transplantation. Treatment options: Umbilical cord blood stem cell injection method, the number of cells (2 × 107 ~ 3 × 107) / copies. The first one was intravenous injection, while the rest were all transpedicular lumbar puncture. Safety indexes and cerebral motor function comprehensive assessment and gross motor function measure (GMFM) were used before and after treatment respectively. Results The statistical results showed that there was no significant difference in the safety index before and after treatment in children (P> 0.05). There were significant differences in the comprehensive functional assessment score and GMFM score between before and after treatment (P <0.05). Further analysis found , And the total effective rate of functional assessment of cerebral palsy was 73.3%, and the improvement of motor function and verbal function were the most significant (P <0.05) before and after the scores of each functional area, while the scores of functional areas of GMFM before and after Comparison, supine, prone and seat function improvement was statistically significant (P <0.05). CONCLUSION: Umbilical cord blood stem cells are safe and effective for the treatment of severe cerebral palsy, especially in the improvement of motor function and speech function. Among them, the functions of supine motor, prone position and sitting function are obviously improved.