儿童抽动障碍65例临床分析

目的 探讨儿童抽动障碍的临床特点。方法 总结2000年1月至2002年12月门诊诊断为儿童抽动障碍的患儿65例，对照相关文献进行综合分析。结果 诊断为抽动障碍的65例儿童中，以男性为主，多见于学龄儿童，平均年龄为8.4岁；以眨眼及吸鼻症状多见，各占83％和60％，而精神症状(以多动为主)则作为伴随症状出现；出现症状或原有症状加重前2周左右有上呼吸道感染病史者42例，占64.5％，其中链球菌感染指标检查异常者10例，占35.7％；本病误诊率极高，总误诊率为52.3％(34/65)；神经电生理检查、颅脑MRI检查均未发现异常病灶；可不医自愈。结论 儿童抽动障碍是儿童较为常见的神经精神障碍性疾病，临床上还没有特征性的诊断指标，临床误诊率极高。

A study of 65 patients with children''''s tic disorder

Objective To explore the clinical characteristic of children's tic disorder.Methods A total of 65 child outpatients diagnosed with tic disorder from January 2000 to December 2002 were analyzed.Results Most of the 65 children were male school age pupils averaging 8.4 years.Most common symptoms identified were blinking(83%) and nostrils flaring(60%);psychic symptoms(such as raising eyebrows,grimacing,opening the mouth,et al) were present as concomitant symptoms;42 cases(64.5%) had upper respiratory tract infection(rheum) 2 week before the symptom appeared;10 cases(35.7%) in these 42 children got streptococcus infection.Misdiagnose rate of this disease was high,accounting for 52.3%(34/65) in total.No topical lesions were found with EEG and MRI in all the cases.The disorder could disappear without treatment.Conclusion Tic disorder is a regular psychiatric disorder in childhood,there is no clinical diagnostic standard and misdiagnose rate is very high.