摘要
目的:通过回顾病例资料,分析双胎儿脑性瘫痪的患病情况。方法:收集并分析1999-09/2004-12湖南省儿童医院康复中心收治的412例脑性瘫痪中的40例双胎儿的临床资料,包括性别、年龄、出生胎龄、病因、分类及合并症等。结果:此组病例中双胎儿脑性瘫痪构成比为9.71%。①40例中出生顺序为第一产儿16例,第二产儿14例,剖腹产儿10例。男24例,女16例。②40例中出生胎龄为28～32周12例,～37周20例,～42周8例。出生体质量:1500～2000g18例,～2500g12例,～3000g6例,3000g以上4例。③40例中为双胎之大22例,为双胎之小18例,且双胎之大者较双胎之小者病情重;并有20例双胎均患脑瘫,且均为同性双胎。患脑瘫者其同胞为正常儿6例,其同胞宫内死亡4例。④致病因素为早产32例,窒息16例,未发现家族史及遗传病史。⑤40例中痉挛型脑瘫32例,手足徐动型6例,混合型2例。双瘫10例,四肢瘫26例,偏瘫4例。合并智力低下16例,语言障碍6例,视力障碍14例,听力障碍10例,小头畸形4例,癫痫8例,营养不良8例,佝偻病14例。⑥头颅CT正常12例,异常28例;脑电图正常16例,异常24例。结论:双胎儿脑性瘫痪多为同性双胎,窒息、早产、低出生体质量为双胎儿易患脑性瘫痪的主要原因,双胎之大较双胎之小病情重,同性双胎较异性双胎易患脑性瘫痪。临床分型以痉挛型为主,且有多种合并障碍如智力低下等,头颅CT和脑电图异常率较高。提示双胎是脑性瘫痪的独立的高危因素,应加强双胎妊娠的围产期监护和治疗。
AIM： To analyze the prevalence of twinning with cerebral palsy by reviewing the data of the medical record.
METHODS： Clinical data of 40 twinnings among 412 children with cerebral palsy, who were treated at the Rehabilitation Center, Hnnan Provincial Children＇s Hospital from September 1999 to December 2004 were collected and analyzed, which composed of sex, age, gestation age at birth, pathogeny, classification and complication, etc.
RESULTS： The constituent ratio of cerebral palsy in twinnings was 9.71%.① Among the 40 cases, birth order was 16 first infants, 14 second infants and 10 cesarean infants, including 24 males and 16 females. ②In the 40 infants, gestational age was 28-32 weeks with 12 cases, -37 weeks with 20 cases, -42 weeks with 8 cases. Body mass when birthing were 1500-2 000 g with 18 cases, -2 500 g with 12 cases, -3 000 g with 6 cases and over 3 000 g with 4 cases. ③In the 40 cases, the old one between the twins were 22 cases and young one between the twins were 18 cases. The disease of the old one was serious than that of the young one. There were 20 twins with cerebral paralysis, and they were all twins with the same sex. There were 6 cases that had a normal infant in the twin, and 4 infants died in womb. ④Etiological factor. There were 32 premature birth infants and 16 asphyxia infants, and there was no family history and history of genetic disease. ⑤In the 40 cases, there were 32 infants with spasm cerebral palsy, 6 cases with athetosis cerebral palsy and 2 cases with mixed type. There were 10 cases with dipligia, 26 cases with tetraplegia and 4 cases with hemiplegia. There were 16 cases with merger mental retardation, 6 cases with disorder of language, 14 cases with visual disturbance, 10 cases with dysandia, 4 cases with microcephaly, 8 cases with epilepsy, 8 cases with dystrophy and 14 cases with rickets. ⑥There were 12 cases with normal skull CT, 28 cases with abnormality, 16 cases with normal eletroencepalograph and 24 cases with abnormality. CONCLUSION： Most of the twins＇ infants with cerebral palsy are twins with the same sex. Asphyxiation, premature birth and low birth body mass are the main reasons of twins to get cerebral palsy. The old one of the twins has more serious state of an illness than the young one. Twins with the same sex is easy to got cerebral palsy as compared with the twins with. different sex. Clinical typing is mainly spasm, and has many merger handicaps, such as mental retardation, etc. The abnormal rate of skull CT and eletroencepalograph is high. It is indicated that twinning is an independent high risk factor of cerebral palsy. The pefinatal care and treatment of twinning should be improved.
出处
《中国临床康复》
CSCD
北大核心
2006年第8期44-46,共3页
Chinese Journal of Clinical Rehabilitation
