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【目的】探讨早产儿脑瘫的高危因素、脑瘫类型、运动障碍程度、影像学特点及共患病情况。【方法】专科医院为基础的横断面临床研究,研究对象为2006年1月-2010年6月在本院脑瘫康复中心住院治疗的早产儿脑瘫患者,详细记录围生期脑损伤高危因素;采用脑瘫粗大运动功能分级系统(Gross Motor Function Classification System,GM-FCS)评估运动障碍程度;常规进行智力评测、眼科学检查、语言能力评估,怀疑听觉障碍进行脑干听觉诱发电位行听力阈值测试,采用SPSS13.0统计软件进行统计学处理。【结果】早产儿脑瘫以痉挛型最多见(占77.13%)。痉挛型双瘫和偏瘫的GMFCS水平好于不随意运动型、四肢瘫和混合型(F=4.362,P<0.01)。不同脑瘫类型和GMFCS水平的患儿共患病明显不同。占65.89%患儿影像学呈现侧脑室周围白质软化改变,见于各种类型但以痉挛型双瘫和四肢瘫最多,早期影像学检查有利于早产儿脑瘫的早期诊断、分型和预后预测。【结论】认识并掌握早产儿脑瘫的运动学和影像学特征以及各种伴发障碍,对于病因学研究、综合康复管理都极端重要。
【Objective】 To investigate the risk factors of cerebral palsy in children with preterm infants, the types of cerebral palsy, degree of dyskinesia, imaging features and co-morbidity. 【Methods】 A specialist hospital-based cross-sectional clinical study was conducted in children with cerebral palsy who were hospitalized for treatment of cerebral palsy in our hospital from January 2006 to June 2010, and the risk factors of perinatal brain injury were recorded in detail. FCM was used to assess the degree of dyskinesia. The brainstem auditory evoked potentials were routinely tested for intelligence, ophthalmology, speech proficiency, and suspected hearing impairment. SPSS13.0 statistical software for statistical analysis. 【Results】 The most common type of cerebral palsy was premature infants (77.13%). Spastic diplegia and hemiplegia GMFCS levels better than involuntary movement, quadriplegia and mixed (F = 4.362, P <0.01). Children with different types of cerebral palsy and GMFCS had significantly different comorbidities. Accounting for 65.89% of children showed white matter around the periventricular changes in the white matter, found in various types but with spastic diplopathic and quadriplegia the most early imaging examination is conducive to early diagnosis of cerebral palsy in children with preterm children, type and prognosis. 【Conclusion】 Understanding and mastering the kinematics and imaging characteristics of cerebral palsy in children with preterm infants and various associated disorders is extremely important for etiological studies and comprehensive rehabilitation management.