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目的探讨0~6个月婴儿中枢性协调障碍临床表现、高危因素、辅助检查等,以寻求早期诊断该病的临床依据。方法采取回顾性的方法,将112份0~6个月中枢性协调障碍(CCD)患儿病例资料进行统计分析。结果 112例CCD患儿93.75%有一种或多种高危因素,6.25%无明显高危因素。高危因素前五名分别为:剖宫产、早产、低出生体重、新生儿高胆红素血症、羊水污染。112名患儿除7例1~2个月婴儿运动功能水平难以评判外其余105例患儿运动发育指数(PDI)在79~<50分之间,智力发育指数(MDI)<79分占45.71%。异常姿势排序为:握拳、拇指内收、下肢硬性伸展、尖足、肩后伸。Vojta姿势反射3种异常6.25%,4~5种异常32.14%,6~7种异常42.86%,7种异常并有肌张力异常18.75%。肌张力增高77.68%,肌张力降低22.32%。112例患儿头颅影像学检查异常34.82%,脑电图检查异常7.14%。结论难产婴儿是脑损伤高危儿筛查的重点人群;如何减少早产、低出生体重儿童的发生是防治脑损伤下一步工作的重点。0~6个月婴儿CCD的临床表现呈多样化,诊断依据主要在运动、姿势、反射、肌张力方面的异常;姿势反射异常更具有诊断价值。
Objective To investigate the clinical manifestations, risk factors and auxiliary examinations of central coordination disorders in infants aged 0 ~ 6 months in order to seek the clinical basis for early diagnosis of the disease. Methods A retrospective analysis of 112 cases of children with central coordination disorder (CCD) between 0 and 6 months was performed. Results 93.75% of 112 children with CCD had one or more risk factors, 6.25% had no obvious risk factors. The top five risk factors were: cesarean section, premature birth, low birth weight, neonatal hyperbilirubinemia, amniotic fluid contamination. Among the 112 children, the motor function index (PDI) ranged from 79 to <50 and the intelligence development index (MDI) <79 was 45.71 %. Abnormal posture order: fist, thumb adduction, lower extremity rigid stretch, sharp feet, shoulders stretch. Vojta postures reflect 6.25% of 3 abnormalities, 4 ~ 5 abnormalities 32.14%, 6 ~ 7 abnormalities 42.86%, 7 abnormalities and abnormal dystonia 18.75%. Muscle tension increased 77.68%, muscle tension decreased 22.32%. 112 cases of craniocerebral imaging abnormalities 34.82%, EEG abnormal 7.14%. Conclusions Infants with dystocia are the key population for screening high risk children with brain injury. How to reduce the incidence of premature birth and low birth weight children is the focus of the next step of prevention and treatment of brain injury. The clinical manifestations of the CCD in infants from 0 to 6 months are diversified, and the diagnosis is mainly based on the abnormalities in movement, posture, reflex, and muscle tone. Postural reflexes are more diagnostic.