58例脑瘫患儿脑干听觉诱发电位分析

目的研究应用脑干听觉诱发电位(BAEP)检测早期发现脑瘫患儿的听觉通路损害及脑干功能情况。方法应用n icolet肌电诱发电位仪为58例脑瘫患儿进行BAEP检查分析。结果 本组58例脑瘫患儿,异常43例正常15例,异常率74.14%。结论 BEAP检查对早期发现脑瘫患儿听路损害和脑干功能情况有重要意义。     

听力障碍儿童脑干听觉诱发电位48例分析

儿童期听力障碍的主要病因多为后天因素 ,临床所见多数病例是以耳毒性药物和缺氧及黄疸症所致的听力障碍。由于听力障碍会直接影响儿童期语言功能的建立和智能发育。作者对 48例听力障碍的儿童应用脑干听觉诱发电位 (BAEP)进行检测 ,探讨听觉通路的功能状态 ,以求为临床儿童听力障碍的早期诊断 ,及时治疗和预防提供客观依据。1　对象和方法1.1　对象　 48例均为 1999～ 2 0 0 2年来五官科门诊和住院患儿。专科检查患儿均有听力障碍及不能进行正常言语交往 ,经临床诊断为听力障碍的儿童 48例 ,其中男 19例 ,女 2 9例 ;年龄 2～ 10岁 ,平均…     

脑干听觉诱发电位对儿童听力障碍的断诊价值

儿童听力障碍在小儿科、耳鼻喉科的诊断方面,一直是比较棘手的难解决的问题,特别是5岁以下的婴幼儿,由于患儿不能合作,不能用语言准确的表达病情的客观症状,对其听力障碍的诊断更加困难,对耳聋的程度也不能做出客观的评价。我科从1988年—1993年对35例听力障碍的儿童进行了脑     

听力障碍高危儿147例脑干听觉诱发电位临床分析

【目的】通过对听力障碍高危儿的脑干听觉诱发电位（brainstem auditory evoked potential，BAEP）分析，探讨高危因素与听力损伤程度、损伤部位及预后的关系。【方法】从2002年1月～2004年6月，选取在本院儿保高危儿专科门诊随访的42d～3个月的高危儿863例作为研究对象，进行BAEP检查，对147例听力障碍高危儿进行BAEP和临床分析。【结果】资料显示低出生体重、高胆红素血症、母孕期病毒感染、窒息是听力障碍的主要高危因素（占85．7％）。听阈增高轻度62．5％，中度30．6％，重度6．9％。BAEP异常类型中外周障碍型51．7％，脑干障碍型20．4％，外周合并脑干障碍型27．9％。轻、中度听力障碍预后好，重度预后差。【结论】不同高危因素对听力的损伤程度和部位及预后产生不同的影响，BAEP对听力障碍高危儿的早期诊断、干预和预后判断具有重要价值。     

108例脑瘫患儿的脑干听觉诱发电位分析

目的:探讨脑瘫患儿的脑干听觉诱发电位(ABR)与脑瘫类型、程度及并发症之间的关系。方法:采用神经诱发电位仪为108例脑瘫患儿做ABR检查和分析。结果:脑瘫患儿的ABR异常率为73.1%,不随意运动型、混合型、肌张力低下型ABR异常率较高,重度脑瘫组ABR异常率较高,伴语言障碍、智力障碍患儿的ABR异常率较高。结论:脑瘫患儿的ABR异常率较高,与大脑损伤部位和程度有关,ABR检查应作为脑瘫患儿的常规检查。     

脑干听觉诱发电位在儿科的应用

脑干听觉诱发电位 (ＢＡＥＰ)是一种无创伤性的电生理检测技术 ,已逐步应用于儿科各类疾病。现将我院儿科应用ＢＡＥＰ检测资料分析如下。1　资料和方法1.1　对象　 1995～ 1998年对 344例患儿进行了ＢＡＥＰ检测 ,男 2 45例 ,女 99例 ;<1岁 41例 ,1～ 3岁 94例 ,3～ 7岁 12 2例 ,7～ 14岁 87例。1.2　方法　使用ＷＤ 40 0 0Ⅲ型神经电位诊断仪 ,检测方法及正常标准与潘氏[1] 相同。异常标准 :①各波缺失。②各波潜伏期、峰间期延长 (> ｘ + 3ｓ)。③Ⅲ～Ⅴ间期 >Ⅰ～Ⅲ间期。④Ⅴ波潜伏期两侧之差 >0 .3ｍｓ ,长的一侧为异常。⑤Ⅴ /Ⅰ波幅…     

脑干听觉诱发电位在术中监测中的应用

脑干听觉诱发电位是指给耳高频短声刺激后在大脑皮层记录到的电位,临床广泛用于颅脑肿瘤的手术监测中,术中通过对潜伏期和波幅的监测,对帮助术者保护神经功能及判断预后脑干功能有重要价值。     

脑干听觉诱发电位和40Hz听觉诱发电位在职业性噪声聋诊断中的应用

目的 探讨脑干听觉诱发电位(ABR)和40 Hz听觉诱发电位(40 Hz AERP)在职业性噪声聋诊断中的应用,为其诊断提供客观依据.方法 对54名噪声作业工人分别进行纯音测试、ABR及40HzAERP测试,对高频段及3、4 kHz处阈值与ABR反应阈值及语频段、0.5 kHz处阈值与40 Hz AERP反应阈值进行比较分析.结果 ABR反应阈值与高频段纯音听阈相关性较好;40 Hz AERP反应阈值与语频段纯音听阈比较差异较大,40 Hz AERP与语频段纯音听阈之间的校正值:轻度噪声聋组为(16.43±1.08) dBn HL,中度噪声聋组为(11.80±1.12) dBn HL.结论 在职业性噪声聋诊断中,ABR反应阈值能客观地预估纯音高频听阈,语频听阈与40 Hz AERP差异较大,不能将反应阈值误认为听阈值,而应进行反应阈值与校正值计算,得出估计的行为听阈值.     

100例聋哑症听觉脑干诱发电位分析

我们自1989年7月～1993年5月对100例聋哑症患者做了听觉脑干诱发电位检查,现将结果分析报告如下。资料和方法本组100例,男56例,女44例;年龄2～22岁,平均年龄5岁。主要病史(根据父母、亲属提供)耳毒性抗生素(链霉素、庆大霉素、卡那霉素)用药过量中毒29例,原因不明67例,其它4例(幼时患中耳炎、大脑炎、鼓室硬化及家族遗传者各1例)。     

96例听力障碍儿童脑干听觉诱发电位检测结果分析

为探讨儿童保健工作中引入听力筛查的必要性和方法 ,对 96例听力障碍儿童进行脑干听觉诱发电位 (BAEP)检测。结果显示 91.37%的患儿BAEP异常 ,重度听力损害占 41.6 7%。由于BAEP检测无损伤 ,重复性好 ,不受儿童年龄和意识水平的影响 ,是婴幼儿优良的早期听力筛查工具     

性别和年龄对脑干诱发电位的影响研究

目的 探讨性别和年龄对脑干听觉诱发电位的影响。方法 检测53例（106耳）正常人的BAEP,用多元线性相关分析和逐步回归分析对其进行分析。结果 20－58岁期间的正常人Ⅲ波潜伏时、Ⅰ-Ⅲ及Ⅲ-Ⅴ峰间期与年龄有线性相关,但相关不高;Ⅰ、Ⅲ波潜伏时及Ⅲ－Ⅴ峰间期与性别有线性相关关系,其相关性亦不高,V波潜伏时及I－V峰间期与性别有线性相关关系,其相关较高;女性各波潜伏时及峰间期均较男性短,其中以V波潜伏时表现更为明显,比男性短0.2ms。结论 性别和年龄是影响BAEP的两个主要生理因素。在临床应用时,如能排除其影响,诊断则更客观、准确。     

Transport Mobility for Children and Adolescents with Cerebral Palsy (CP)

Background: The transport mobility of children and adolescents with cerebral palsy (CP) is of vital interest for the individual, as well as for society. Enhanced transport mobility can be related to improved functional health status and a higher degree of autonomy, which in turn may reduce the demand for societal support. UN Resolution 48/96, together with Swedish legislation and ''Vision Zero'' have in different ways established that the transport system must be designed to meet also the needs of children and adolescents with disabilities. Hence, it is necessary to identify and eliminate obstacles hindering children and adolescents with CP from using public transport and other means of transport, such as their own cars, at the same level as other members of society. However, in the case of children and adolescents with CP, the transport situation and the learner driver's educational situation have so far been largely unknown. Aim: The general aim of the thesis was to describe and analyse, from a legislative and a public health perspective, the transport mobility situation for children and adolescents with CP. Furthermore, the general aim was to identify obstacles for the target group to use public transport and other means of transportation, at the same level as other members of the society, and to suggest improvements that will remove the identified obstacles. Material and methods: Several different data collection methods were used. Data, concerning travel habits and parents' perceived risks regarding transportation, were taken from a postal questionnaire addressed to parents of children and adolescents with CP. In order to estimate the numbers of potential learner drivers with CP in each age group in Sweden, a literature review was conducted, based on Swedish material. Furthermore, logbooks for learner drivers with CP were analysed retrospectively, in order to identify procedures, problems and key tasks in their driver education. Visual search strategies for learner drivers with CP were analysed, utilizing an eye tracker, and an attempt was made to introduce a screening tool for predicting the outcome of driver education. Results: Children and adolescents with CP were found to be transported under unsafe conditions, causing worry among their parents. When transporting children in the family vehicle, the parents were exposed to a very heavy burden, which increased their worry. The prevalence of potential learner drivers with CP who were in need of highly specialised driver education, including individually adapted driver training vehicles, was estimated to be 0.15 per 1,000 of a population-based age group of learner drivers in Sweden. Complex procedures, structural problems and financial obstacles made it difficult for adolescents with CP to obtain a driving licence and an adapted vehicle. The total duration of the driving tuition given by a driving instructor was found to be almost nine times higher for learner drivers with CP than for non-disabled learner drivers. Visual search strategies among learner drivers with CP were found to be less flexible than among other learner drivers. This fact indicated a need for better methods of teaching such strategies to this group as an integral component of their driver education. The validity of the motor-free visual perceptual test, TVPS-UL, for predicting the outcome of driver education for learner drivers, was found to be low. In order to find a reliable and valid screening tool for this purpose, future studies should focus on cross-validation of visual perceptual and dual task performance tests for different types of independent variables, such as obtaining a driving licence or not, accident involvement and driving ability. Conclusion: The transport system was found, from a legislative and public health perspective, to be unsuitable to meet the needs of children and adolescents with CP. Suggestions for improving transport mobility for children and adolescents with CP are provided. Several of these suggestions are practical, concrete and contextual for Swedish conditions, and some of them necessitate future research. However, a number of these suggestions are also applicable in an international context.     

上海市7岁以下儿童听力障碍流行病学研究

目的 调查上海市７岁以下儿童听力障碍现患情况及原因探索。方法 用测听仪器检测受调查儿童。结果 听儿障碍的现患率为３．４３％。市区以中、轻度为多，效县以重度以上为主（Ｐ〈０．０５）。〈３岁以重度以上为多，≥３岁以轻度为主（Ｐ〈０．０５）。致小儿听力障碍的危险因素主要是曾用过耳毒性药物和婴幼儿期曾患疾病史（包括头颅外伤、反复上呼吸道感染和渗出性中耳炎）。结论 要进一步健全全市听力筛查网络，提高检测水平、尤其是效县。儿童应禁用中毒性药物；对有既往疾病史的高危儿童，要重点进行听力检测，做到早发现、早干预，早期康复。     

引导式教育在小儿脑瘫康复治疗中的应用研究

目的：讨论应用引导式教育对小儿脑瘫患者进行康复治疗的临床效果。方法：选取2011年9月-2013年8月本院收治的100例脑瘫患儿,按随机数字表法分为观察组和对照组各50例,其中对照组采用常规康复训练手段,观察组在对照组的基础上实施引导式教育,观察两组患儿的临床效果。结果：对照组总有效率为72.0%,显效率为56.0%;观察组总有效率为94.0%,显效率为70.0%。观察组的临床疗效明显高于对照组,差异有统计学学意义（P〈0.05）。结论：对于小儿脑瘫患者来说,应用引导式教育具备着显著的临床效果,值得在临床治疗中进行推广应用。     

康复治疗小儿脑瘫的临床疗效分析

目的：讨论应用康复治疗方法对脑瘫患儿进行治疗的临床效果。方法：选取本院2011年7月-2013年6月收治治疗的80例脑瘫患儿,随机数字表法分成观察组与对照组,其中对照组选择常规方法进行治疗,观察组选择康复治疗方法。结果：对照组患儿总有效率为67.5%,显效率为37.5%;观察组患儿总有效率为92.5%,显效率为70.0%。观察组患者的临床效果明显优于对照组。结论：对于脑瘫患儿来说,应用康复治疗方法实施治疗具备着显著的临床效果,可以有效的使患儿得到康复,降低残疾程度,其值得广泛的在临床中被推广使用。     

小儿脑瘫的早期诊断和康复治疗问题探究

目的：探讨小儿脑瘫早期诊断、早期治疗的方法及康复治疗的临床效果。方法：对96例小儿脑瘫的临床资料进行回顾性分析。所有患儿均根据病情给予药物疗法、运动疗法、高压氧舱等综合康复治疗。结果：96例小儿脑瘫经综合治疗后,0~6个月患儿治疗有效率最高为92.68%,7~9个月患儿为83.87%,10个月~4岁患儿最低为62.50%。三组比较差异有统计学意义（P〈0.05）。结论：早期发现、早期诊断、早期干预对保证患儿康复治疗效果、减少小儿脑瘫残障有重要意义。     

Malnutrition and Environmental Stimulation in Rats: Wave Latencies of the Brainstem Auditory Evoked Potentials

It has been shown that environmental stimulation may reduce the damage caused by malnutrition to morphological and behavioural parameters; however, there are no data on the effects of stimulation on the Brainstem Auditory Evoked Potentials (BAEPs). The aim of this study was to evaluate the effects of protein malnutrition, nutritional recovery and environmental stimulation on the BAEPs of the rat. On the first day of life, the animals were divided into Well-nourished (W) and Malnourished (M) groups. At weaning, half the M rats were submitted to nutritional recovery (R) until the test day. All groups were subdivided into Stimulated (S) and Non-Stimulated (N) rats. BAEPs was tested in animals exposed to clicks of 90, 80 and 70 dB of intensity. The BAEPs latencies of waves I, II, III and IV in the left ear were analysed in independent groups of rats on the 14th, 18th, 22nd, 32nd, and 42nd days of age. Statistical analysis showed diet and environmental stimulation interaction on the latencies of waves I, II, III and IV at all tested ages. WN rats showed longer latencies of waves I, II, III and IV than WS rats, and MN rats also showed longer latencies of these waves compared to WN, MS and RN at all tested ages. The results showed that malnutrition caused a delay in the latency of all BAEPs waves in rats of all ages. However, environmental stimulation reduced these latencies, reversing some damage caused by malnutrition. These data suggest that the auditory brainstem pathway is vulnerable to nutritional insults, and its structures show plasticity with environmental stimulation.     

重度未成熟儿致痉挛性脑瘫的MRI表现与分析

目的探讨重度未成熟儿致痉挛性脑瘫的MRI影像学特点。方法经临床诊断66例痉挛性脑瘫患儿,均行MRI颅脑检查。结果66例患儿颅脑MRI表现,脑室周围白质软化45例,伴随胼胝体发育不良18例,脑白质髓鞘发育延迟5例;弥漫性脑软化囊变并脑萎缩6例,局限性脑软化囊变并脑萎缩2例,脑先天发育畸形3例,脑外间增宽3例,宫内感染表现者2例。结论MRI检查重度未成熟儿致痉挛性脑瘫敏感性高,特征性强,可为临床治疗方案选择提供有价值的帮助。     

The Pediatric Subjective Global Nutrition Assessment Classifies More Children With Cerebral Palsy as Malnourished Compared With Anthropometry

BackgroundNutrition assessment is multidimensional; however, much of the literature examining the nutritional status of children with cerebral palsy (CP) focuses on a single dimension.ObjectiveThe aim of the study was to evaluate nutritional status in children and adolescents with CP by comparing results from the Pediatric Subjective Global Nutrition Assessment (SGNA) with results from traditional anthropometric measures.DesignThis study was a cross-sectional observational study.Participants/settingThis study was conducted in a tertiary hospital outpatient setting in Brisbane, Australia, from February 2017 to March 2018. A total of 89 children (63 boys) with CP aged between 2 and 18 years of age were included. All Gross Motor Function Classification System levels were observed. The majority of children were in Gross Motor Function Classification System I and II (57, 64%) compared with Gross Motor Function Classification System III to V (32, 36%). Children with feeding tubes and those acutely unwell or hospitalized were excluded.Main outcome measuresChildren were classified as well nourished, moderately malnourished, or severely malnourished by dietitians using the SGNA. Weight, height, body mass index (BMI), triceps skinfold thickness, subscapular skinfold thickness, and mid upper arm circumference were measured and converted to z scores to account for age and sex differences. Moderate malnutrition was defined by z scores −2.00 to −2.99 and severe malnutrition as ≤−3.00 z scores.Statistical analysis performedMultinomial logistic analyses were used to compare results from the SGNA and each single measurement. Continuous outcomes were transformed into z scores. Agreement was assessed with 2 categories: not malnourished and malnourished. Comparison statistics included percent agreement, sensitivity, and specificity.ResultsMore children were classified as moderately or severely malnourished by SGNA than any of the anthropometric z score cutoffs. The majority of children were well nourished (n = 63) with 20 (22%) moderately malnourished and 6 (7%) severely malnourished by SGNA. The SGNA classified 11 children as malnourished that were not classified as malnourished by BMI. Children with moderate or severe malnutrition by SGNA had lower weight (P < .001, P < .001), BMI (P < .001, P < .001), mid upper arm circumference (P < .001, P < .001), triceps skinfold thickness (P = .01, P = .007), and subscapular skinfold thickness (P = .005, P = .02) z scores than well-nourished children.ConclusionThe SGNA identified more potentially malnourished children including children classified as well nourished by the single measurements such as BMI, height, and weight. The SGNA provided a clinically useful multidimensional approach to nutrition assessment for children with CP.