目的 了解沈阳市6~30月龄脑瘫(CP)患儿的头颅形状,并分析其与贝利婴幼儿发育量表(BSID)中智力发育指数(MDI)之间的相关性,为促进CP患儿智力发育提供依据。方法 选取2017年2－9月就诊于沈阳市4家具有儿童脑康复科室的医院663例CP患儿为病例组,对照组为587例非CP婴幼儿,采用STAR激光扫描仪对受试对象进行颅形扫描,BSID评价智力发育水平。结果 1)病例组663名患儿头颅畸形发生率为40.7%,轻度及中重度畸形发生率分别为29.3%、11.4%;对照组587名幼儿头颅畸形发生率为31.7%,轻度及中重度畸形发生率分别为20.9%、10.8%。病例组头颅畸形率显著高于对照组(χ2=2.612,P＜0.05),轻度和中重度畸形程度分级也高于对照组,差异有统计学意义(χ2=3.217、1.534,P＜0.05)。2)BSID显示病例组中43.7%智力发育迟滞(MDI≤69),随着头颅畸形严重度增加,MDI逐渐降低,差异有统计学意义(χ2=0.025,P＜0.05)。结论 头颅畸形与智力发育有关,可能是智力发育迟缓的一个风险指标,尤其在CP患儿。在儿童保健工作中医师及家长要重视头颅形状与智力发育的关系,重视对婴幼儿头形进行检查,减少头颅畸形发生率。
Abstract
Objective To understand the cranial shape of 6 to 30 month-old children with cerebral palsy (CP) in Shenyang,and to analyze its correlation with the mental development index (MDI) in the Bayley Infant Development Scale (BSID),in order to provide reference for promoting MDI in CP children. Methods Totally 663 CP children in four hospitals in Shenyang were selected as case group,and 587 non-CP children were selected as control group from February to September 2017. The STAR laser scanner performed a skull scan on the participants and the level of mental development was assessed with BSID. Results 1) The prevalence rate of cranial malformations was 40.7% in the 663 CP patients in the case group,29.3% and 11.4% for mild and moderately severe cases,respectively. The rate of cranial malformations was 31.7% in 587 non-CP children,20.9% and 10.8% for mild and moderately severe malformations. And the rate of cranial malformations in case group was significantly higher than that in control group (χ2=2.612, P<0.05),and so were for mild and moderately severe malformations (χ2=3.217,1.534, P<0.05). 2) Totally 43.7% of children in case group were screened as mental retardation (MDI≤69). And with the severity of head malformation increasing,MDI gradually decreased (χ2=0.025,P<0.05). Conclusions Cranial malformations are associated with mental development and may be a risk indicator of mental retardation,especially in children with CP. Medical staff and parents should pay attention to the relationship between skull shape and intelligence development,attach importance to the inspection of the head shape of infants,in order to reduce the incidence of skull deformity.
关键词
头颅畸形 /
斜头畸形 /
脑性瘫痪 /
智力发育迟滞 /
婴幼儿
Key words
skull deformity /
oblique head deformity /
cerebral palsy /
intellectual retardation /
infants
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