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目的:探讨早产儿脑性瘫痪的病因诊断以利防治。方法:对2002年11月～2005年12月我院早期干预门诊经确诊258例早产儿脑瘫分析其病因、早期临床表现及头颅CT象征,进行体格神经系统检查并智测。结果:(1)异常分娩史124例(46.1%),高危因素以窒息、HIE、ICH、高胆、肺部疾病、感染、惊厥为主,各为121例、65例、58例、78例、43例、66例、12例。(2)6个月以内确诊的脑瘫28例的临床表现,以反应差、嗜睡、少吃、哭、动,肌张力低下或增高,反射及姿势异常,发育明显落后。(3)身长、体重、头围、MDI和PDI各为73.24cm±9.82cm、9.12kg±2.31kg、44.15cm±3.47cm、44.42分±6.09分、43.80分±4.95分。(4)头颅CT表现异常率为95.4%。(5)发育落后,258例早产儿脑瘫发育落后情况,身长、体重、头围(<2SD)各为123例、90例、148例,MDI、PDI>70分各为5、4例,余均<50分,癫痫3例,语言落后78例,听力障碍42例。结论:当早产儿具有高危因素,异常临床表现与神经症状、发育明显落后,应结合头颅CT密切随访可早期诊断脑性瘫痪及早干预。
Objective: To explore the etiological diagnosis of cerebral palsy in premature infants to facilitate prevention and treatment. Methods: From November 2002 to December 2005, 258 cases of cerebral palsy diagnosed in early interventional clinic of our hospital were analyzed for etiopathogenisis, early clinical manifestations and cranial CT signs, and their physical and neurological examination was performed. Results: (1) 124 cases (46.1%) had abnormal delivery history. The risk factors included asphyxia, HIE, ICH, hypercholesteremia, pulmonary disease, infection and convulsion, 121 cases each, 65 cases, 58 cases and 78 cases , 43 cases, 66 cases, 12 cases. (2) The clinical manifestations of cerebral palsy diagnosed within 6 months were poor in response, drowsiness, emaciation, crying, dysthymia, low or high muscle tone, reflex and postural abnormalities. (3) Body length, body weight, head circumference, MDI and PDI were 73.24cm ± 9.82cm, 9.12kg ± 2.31kg, 44.15cm ± 3.47cm, 44.42 ± 6.09 and 43.80 ± 4.95 respectively. (4) Head CT abnormal rate was 95.4%. (5) The development and backwardness in 258 premature infants with cerebral palsy were lagged. The body length, body weight and head circumference (<2SD) were 123 in each, 90 in 148 and 148 in MDI and PDI> 70 All <50 points, 3 cases of epilepsy, 78 cases of language behind, 42 cases of hearing impairment. Conclusion: When preterm children with high risk factors, abnormal clinical manifestations and neurological symptoms, development was significantly behind, should be combined with close follow-up of head CT can be early diagnosis of cerebral palsy and early intervention.