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早期干预治疗痉挛型脑瘫高危儿疗效分析

ISSN号：1672-7606
期刊名称：河南大学学报(医学版)
时间：2013.8.8
页码：215-220
分类：R742.3[医药卫生—神经病学与精神病学;医药卫生—临床医学]
作者机构：[1]河南大学神经生物学研究所,河南开封475004, [2]开封市儿童医院,小儿脑瘫康复科,河南开封475000
相关基金：中国国家自然科学基金面上项目（30771140,31070952,U1204311）.
相关项目：Cajal-Retzius细胞促进移植干细胞在脑片上有序分化的实验研究

关键词：早期干预, 高危儿, 脑性瘫痪, 运动疗法, Early intervention therapy , high-risk infants , cerebral palsy , exercise therapy

中文摘要：

目的观察对痉挛型脑瘫高危儿进行早期干预治疗的效果。方法共选取67例脑瘫高危儿为研究对象，按开始治疗的年龄不同，分为1～3 mon开始治疗的超早期干预组（36例），4～6 mon开始治疗的早期干预组（31例）；每组均采用Bobath和Vojta相结合的运动疗法，单唾液酸四己糖神经节苷脂钠针（Momosialotetrahexosylgan-glioside Sodium Injection ，GMI ）20mg加入质量分数为5％葡萄糖注射液中静脉注射，共治疗3 mon；采用Gesell评测法，肌张力检查，Vojta姿势反射发育，头部CT等对患儿进行治疗前后评估；3 mon后采用Gesell发育量表测出2组患儿发育商（DQ）和发育年龄（DA ），并进行比较。结果经3 mon治疗后，2组患儿的发育年龄（DA ）较实际年龄（CA ）均落后，超早期落后程度低于早期组；患儿 DQ值，肌张力，异常姿势改善方面都取得了较好的疗效，同组治疗前后比较，有统计学差异（P ＜00．1）；2组治疗后比较，差异亦具有统计学意义（P ＜00．1）；头部CT亦较前改善。结论早期干预治疗可改善脑瘫高危儿症状，年龄越小，效果越好。

英文摘要：

Objective The study tried to analyze the therapeutic effect of early intervention treatment on high-risk spastic type cerebral palsy .Methods Totally 67 infants with high-risk cerebral palsy were divided into the super early intervention group （ 1~3 months old , n=36 cases） and the early intervention group （ 4~6 months old , n=31 cases） ,according to the age for treatment . Each group was treated with the exercise therapy , which is Bobath rehabilitation combined with Vojta rehabilitation . Finally , momosialotetrahexosylganglioside sodium infusion was carried out with 5% glucose . The treatment period lasted for 3 months . Then , the treatment evaluation was performed based on Gesell assessment law , muscle tension inspection , Vojta posture reflection , and image alterations of brain CT before and after treatment .The Gesell developmental scales were used to test the development quotient（DQ） and development age（DA） of two groups after 3 months treatment . Results After 3 months training , the scores of DA is lower than CA of two groups , the super early intervention group has higher scores than the early intervention group . The scores of DQ , muscle tension , Vojta posture reflection and CT images were improved well in two treatment groups . The infants , symptoms were improved well after treatment in either super early intervention group or early intervention group with significant difference （P 〈 0 .05 ） . Comparing between the two groups , the efficacy of super early intervention group was much better than early intervention group after treatment , suggesting early therapy is necessary for the disease .Conclusion Early intervention treatment on high-risk cerebral palsy has significant effects on symptoms , and early therapy is necessary for the high-risk infants .

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