摘要
目的探讨新生儿基底节病变的临床转归。方法在我院康复治疗的新生儿期基底节病变患儿为观察组,按病因分为窒息组,宫内缺氧组和胆红素脑病组,均给予早期综合干预至18个月,患儿分别在6、9、12个月时行头颅MRI检查,6、12、18个月时做智力检查,并与健康新生儿组成的对照组进行比较。结果观察组57例,其中窒息组21例,宫内缺氧组20例,胆红素脑病组16例;对照组20例。观察组各组6个月时,MRI基底节病变恢复比较差异无统计学意义(P>0.05),9、12个月时,窒息组、宫内缺氧组较胆红素脑病组MRI恢复率高(P均<0.05);窒息组、宫内缺氧组脑性瘫痪发生率低于胆红素脑病组(P<0.05),6个月时MRI基底节恢复正常的患儿无脑性瘫痪发生;18个月时,观察组3组大运动、精细动作、适应行为3个能区发育商与对照组差距均缩小,但语言、个人社交2个能区发育商改善不明显。结论新生儿基底节异常信号如6个月未恢复,则提示预后不佳,有出现智力落后及脑性瘫痪可能;新生儿基底节病变可导致认知障碍,目前早期综合干预治疗方法不理想,应引起重视。
Objective To investigate the clinical outcome of newborns with basal ganglia lesions. Methods The objective group was 57 infants with neonatal history of the basal ganglia lesions who received rehabilitation treatment in the People＇s Hospital of Guilin. According to etiology, these infants were divided into asphyxia, intrauterine hypoxia and bilirubin encephalopathy groups. All objectives were given early comprehensive intervention until 18 month-old. Brain MRIs were investigated at 6, 9, 12 months and mental examination was conducted at 6, 12, 18 months. The results were compared with the healthy control group. Results MRI basal ganglia changes of the three group showed no significant difference at 6 months old （P 〉0. 05）. At 9 and 12 months, the MRI recovery rate of asphyxia and intrauterine hypoxia group were higher than bilirubin encephalopathy group （ P 〈 0. 05 ）. The incidence of cerebral palsy in asphyxia and intrauterine hypoxia group were lower than bilirnbin encephalopathy group （ P 〈 0. 05 ）. No cerebral palsy occurred later if MRI recovered to normal at 6 months old. After 18 months intervention, the development quotients on the field of gross motor, fine motor and adaptive behavior improved but no obvious improvement on the field of language or personal social ability. Conclusion Patients whose MRI signals of basal ganglia lesions cannot recover to normal at 6-month-old may suffer from mental retardation or cerebral palsy. Neonatal basal ganglia lesion can lead to cognitive impairment. Current early comprehensive interventions do not have significant effect to improve the clinical outcomes.
出处
《中国新生儿科杂志》
CAS
2010年第3期143-145,共3页
Chinese Journal of Neonatology
关键词
磁共振成像
基底节
婴儿
新生
发育障碍
Basal ganglia
Infant, newborn
Magnetic resonance imaging
Developmental disabilities
