全身运动质量评估结果与脑损伤患儿肌张力变化的相关性分析

目的探讨全身运动(GMs)评估结果与脑损伤患儿肌张力变化的相关性。方法选取蚌埠医学院第一附属医院NICU监护治疗并定期门诊随访的脑损伤患儿266例,按全身运动评估结果分为GMs正常组与GMs异常组,统计各组中肌张力正常和异常的例数,分析GMs结果 早产和足月阶段正常GMs (N)、正常不安运动(NF)、单调性GMs (PR)、痉挛-同步性GMs (CS)、不安运动缺乏(F-)]与肌张力变化的关系。结果两组正常GMs (N、NF)患儿肌张力变化比较差异无统计学意义(P>0. 05)。N组患儿肌张力与CS组比较差异有显著性(P<0. 01);N组患儿肌张力与PR组比较差异无显著性(P>0. 05),PR组与CS组肌张力变化比较,差异有统计学意义(P<0. 05)。NF组患儿肌张力与F-组比较差异有显著性(P<0. 01)。全部阶段正常GMs组患儿肌张力与全部阶段异常GMs组比较差异有统计学意义(P<0. 01)。正常GMs组肌张力正常比例较高(76. 92%,67. 74%);异常GMs (CS、F-)组肌张力异常比例较高(64. 86%,84. 38%);肌张力变化与GMs结果之间有一定相关性。结论肌张力异常是GMs异常的高危因素。对无条件开展GMs评估的机构,应首先对肌张力进行评估。对肌张力明显异常、并且有脑损伤高危因素的患儿,应尽早给予专业的康复干预,避免遗留神经系统后遗症。

A study on the correlation between the quality assessment of general movements and the changes of muscular tension in brain damaged infants

Objective To study the correlation between the assessment results of general movements( GMs) and the changes of muscle tension in brain damaged infants. Methods A total of 266 children with brain injury,who were treated by NICU and followed up regularly,were selected from The First Affiliated Hospital of Bengbu Medical College. We divided them into the normal group of GMs and the abnormal group of GMs. Statistics were made on the number of normal muscle tension and abnormal muscle tension in each group,and the correlation between GMs results and changes of muscle tension was analyzed. The GMs results we mentioned above consists of Normal general movements at preterm and full term( N),Normal Fidgety movements( NF),Poor repertoire GMs( PR),Cramped-Synchronized GMs( CS)and absence of Fidgety movements( F-). Results There was no significant difference in the changes of muscle tension between the two groups of normal GMs( N,NF)( P>0. 05). There were significant differences between N group and CS group( P<0. 01). There was no significant difference between N group and PR group( P>0. 05). There was a significant difference between PR group and CS group( P<0. 05). There was a significant difference between NF group and F-group( P<0. 01). The difference between the normal GMs group and the abnormal GMs group in all stages was statistically significant( P< 0. 01). In the normal GMs group,the proportion of normal muscle tension was higher( 76. 92%,67. 74%). In the abnormal GMs( CS,F-) group,the proportion of dystonia was higher( 64. 86%,84. 38%). There was a correlation between changes in muscle tension and GMs results. Conclusion Dystonia is a high risk factor for GMs abnormality. For the institutions which cannot conduct GMs assessments,muscle tension assessment should be conducted firstly. For the children with obvious dystonia and high risk factors of brain injury,professional rehabilitation intervention should be given as soon as possible to avoid sequelae of the nervous system.