矮小儿童的诊断和治疗

目的对205例身高低于同龄及同性别正常儿童均值减2个标准差或第三百分位数以下儿童进行临床研究.方法采用统一调查表进行病史询问、体格检查、各项辅助检查和治疗.结果205例矮小儿童中垂体性侏儒75例为36.6%,其身高、骨龄均显著落后,其中64.0%(48/75)有臀位、横位等难产窒息史,r-hGH治疗效果显著;非垂体性侏儒91例为44.4%(91/205),其中甲状腺功能低下、体质性生长发育延迟及脑发育不全占70例,为76.9%(70/91),甲状腺功能低下者骨龄显著落后于其他非垂体性侏儒,甲状腺素替代治疗效果满意;遗传性疾病39例,为19.0%(39/205),骨龄均正常,其中21-三体综合征28例,为71.8%(28/39),智力低下较其他遗传性疾病明显.结论矮小儿童中以垂体性侏儒、非垂体性侏儒和遗传性疾病常见.避免臀位等难产窒息、开展产前诊断及新生儿筛查是必要的.

Diagnosis and treatment of microsomia children

Objective To investigate the clinical characteristics of 205 microsomia children whose mean stature is lower than that of the same age and same sex 2SD or who is under the third percentage . Methods Uniform investigation table was adopted for diseased history , physical examination and all kinds of laboratory tests. Results Among the 205 cases of the microsomia children , 75 of them (36. 6 %) were pituitary dwarfism . They are stunt remarkablely in stature and bone age,64. 0 % of whom had breech presentation,cross birth , dystocia or asphyxia history. The treamental effectiveness by r-hGH was obviously. The number of the non-pituitary dwarfism children was 91 cases (44.4 %) . Among them, 70 cases (76.9 %) had the symptom of hypothyro-idism , constitutional developing delay and atelencephalia . The bone age of the hypothyroidism children was lower than that of the no-hypothyroidism one's. The treatment with the substitution of thyroxine had a good result. The number of the children with inherited disease was 39 case (19.0 %). The bone age was normal. Among them, 28 cases (71.8 %) were 21-trisomy syndrome children, hypophre associated with the 21-trisomy syndrome was more serious than that related to other kind of inherited diseases. Conclusion The pituitary dwarfism , no-pituitary dwarfism and inherited diseases are the common types in the microsomia children . The measure to improve the situation is to qualify the circumnatal period j avoid the opportunity of breech presentation , dystocia and asphgxia ; perform the pre-natal check-up.