CT、体感诱发电位评价小儿脑性瘫痪脑功能损害程度的敏感性分析

目的评价脑性瘫痪(简称脑瘫)患儿脑损害程度的敏感客观指标,为脑瘫诊断早期全面评价大脑损害程度,制定全面干预方案、判断预后提供客观指标。方法对62例临床确诊的脑瘫患儿同期(1周内)做CT、体感诱发电位(SEP)检查。相同方案治疗3疗程后,35例患儿复查相同检查。结果CT检查阳性率60%,SEP阳性率94%,χ2=16,P<0.005;治疗3疗程后35例复查CT、SEP的患儿,2例CT稍有改变,25例SEP潜伏期、波形有较明显改善。(χ2=29.18,P<0.005)。结论SEP评价脑瘫患儿脑损伤较CT敏感性高,从潜伏期、波幅等方面较易定量,可根据治疗前后变化,作为评价治疗效果的客观指标。

CT and SEP in evaluation of the degree of brain functional lesions in children with cerebral palsy

Aim To explore a sensitive and objective method for evaluate the degree of brain lesions in children with cerebral palsy.Methods Sixty-two children with clinically definitive cerebral palsy, 38 males and 24 females, aged 6- 36months, including 47 cases of spasm palsy and 15 cases of chalasia palsy, were received computerized axial tomography(CT) scan and somatosensory evoked potential (SEP) examination simultaneously within a week since the disease was diagnosed. After 3 courses of treatment, 35 suffered children received the same re-examinations.Results 60% of the children showed a positive result in CT scan, while SEP gives a positive result in 94% of the children.The SEP was significantly sensitive than that of CT scan(χ 2=16, P< 0.005). In the 35 children who received re-examination, only 2 displayed a subtle changes in CT scan, and in contrast, 25 cases showed a obvious improvement in the field of the latency and waveform of SEP (χ 2=29.18, P< 0.005).Conclusion SEP is more sensitive than CT scan in assessing the degree of brain lesion in children with cerebral palsy. With its parameters of latency and waveform, SEP provides a quantitative objective measurement for the changes before and after treatment.