本文選題：兒童 + 腦性癱瘓　； 參考：《重慶醫(yī)科大學(xué)》2012年碩士論文

【摘要】：目的：總結(jié)腦癱患兒合并周圍神經(jīng)病變的特點(diǎn),探討其可能的機(jī)制。 方法：選擇2010年2月-2011年11月期間于重慶醫(yī)科大學(xué)附屬兒童醫(yī)院康復(fù)科首次診斷為腦癱的患兒70例,對(duì)其臨床表現(xiàn)、周圍電生理檢測(cè)及神經(jīng)系統(tǒng)影像學(xué)結(jié)果進(jìn)行分析。 結(jié)果： 1、70例患兒中周圍神經(jīng)傳導(dǎo)異常的患兒有45例(60.0%),其中僅有9例(12.9%)表現(xiàn)為相應(yīng)肢體肌張力降低伴腱反射減弱。 2、周圍神經(jīng)傳導(dǎo)功能檢測(cè)以F波或H反射的異常率最高(71.1%)。 3、周圍運(yùn)動(dòng)神經(jīng)的肌肉復(fù)合動(dòng)作電位(CMAP)及周圍感覺神經(jīng)的動(dòng)作電位(SNAP)的異常率(CMAP28.9%,SNAP44.4%)明顯高于神經(jīng)傳導(dǎo)速度(MCV、SCV)及反應(yīng)電位的遠(yuǎn)端潛伏期(DML)的異常率(MCV6.7%, SCV2.2%, MDML6.7%)。 4、腦白質(zhì)髓鞘化延遲及腦室旁白質(zhì)軟化與周圍神經(jīng)傳導(dǎo)速度降低存在相關(guān)性。 結(jié)論：腦癱患兒周圍神經(jīng)傳導(dǎo)功能檢測(cè)異常率高,但具備周圍神經(jīng)典型臨床表現(xiàn)的患兒比例少,臨床容易漏診或誤診。F波和H反射可能是提示腦癱患兒周圍神經(jīng)病變最靈敏的指標(biāo)。周圍神經(jīng)病變的部位在神經(jīng)的近段,并可能波及脊髓前角細(xì)胞。腦癱患兒周圍神經(jīng)軸索病變較髓鞘病變嚴(yán)重。腦白質(zhì)髓鞘化延遲或腦室旁白質(zhì)軟化的患兒其周圍神經(jīng)纖維與中樞神經(jīng)纖維同時(shí)存在髓鞘病變現(xiàn)象。
[Abstract]:Objective: to summarize the characteristics of children with cerebral palsy complicated with peripheral neuropathy and to explore its possible mechanism. Methods: from February 2010 to November 2011, 70 children with cerebral palsy were first diagnosed as cerebral palsy in the Department of Rehabilitation, affiliated Children's Hospital of Chongqing Medical University. For its clinical manifestations, Results: (1) among 70 children with abnormal peripheral nerve conduction, 45 cases had abnormal peripheral nerve conduction, among which only 9 cases showed hypotonia of limbs and decreased tendon reflex. In peripheral nerve conduction function detection, the abnormal rate of F-wave or H-reflex was the highest (71.1%). 3. The abnormal rate of muscle compound action potential (CMAPP) of peripheral motor nerve and action potential of peripheral sensory nerve (SNAP) was significantly higher than that of nerve conduction velocity (MCV SCV) and nerve conduction velocity (MCV SCV). The abnormal rate of the distal latency and DMLs of the response potential was higher than that of MCV 6.7g, SCV2.2 and MDML6.70.There was a correlation between delayed myelination of the white matter and leukomalacia in the ventricle and the decrease of the conduction velocity of peripheral nerve. Conclusion: the abnormal rate of peripheral nerve conduction in children with cerebral palsy is higher than that in children with cerebral palsy. However, the proportion of children with typical clinical manifestations of peripheral nerve is small, and the clinical misdiagnosis of .F wave and H reflex may be the most sensitive indicators to suggest peripheral neuropathy in children with cerebral palsy. Peripheral neuropathy is located in the proximal segment of the nerve and may affect the anterior horn cells of the spinal cord. Peripheral nerve axonal lesion was more serious in children with cerebral palsy than that in myelin sheath. In children with delayed myelination or ventricular leukomalacia, myelin lesions were found in both peripheral nerve fibers and central nerve fibers.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R742.3

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本文編號(hào)：1985310