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

【摘要】：目的：總結腦癱患兒合并周圍神經病變的特點,探討其可能的機制。 方法：選擇2010年2月-2011年11月期間于重慶醫(yī)科大學附屬兒童醫(yī)院康復科首次診斷為腦癱的患兒70例,對其臨床表現(xiàn)、周圍電生理檢測及神經系統(tǒng)影像學結果進行分析。 結果： 1、70例患兒中周圍神經傳導異常的患兒有45例(60.0%),其中僅有9例(12.9%)表現(xiàn)為相應肢體肌張力降低伴腱反射減弱。 2、周圍神經傳導功能檢測以F波或H反射的異常率最高(71.1%)。 3、周圍運動神經的肌肉復合動作電位(CMAP)及周圍感覺神經的動作電位(SNAP)的異常率(CMAP28.9%,SNAP44.4%)明顯高于神經傳導速度(MCV、SCV)及反應電位的遠端潛伏期(DML)的異常率(MCV6.7%, SCV2.2%, MDML6.7%)。 4、腦白質髓鞘化延遲及腦室旁白質軟化與周圍神經傳導速度降低存在相關性。 結論：腦癱患兒周圍神經傳導功能檢測異常率高,但具備周圍神經典型臨床表現(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病變最靈敏的指標。周圍神經病變的部位在神經的近段,并可能波及脊髓前角細胞。腦癱患兒周圍神經軸索病變較髓鞘病變嚴重。腦白質髓鞘化延遲或腦室旁白質軟化的患兒其周圍神經纖維與中樞神經纖維同時存在髓鞘病變現(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.
【學位授予單位】：重慶醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2012
【分類號】：R742.3

【參考文獻】

相關期刊論文 前6條

1 李瑞花;郭光;林斌;馮小偉;;腦癱患兒免疫功能異常機制初步探討[J];廣東醫(yī)學;2009年11期

2 曹潔;蔡方成;;小兒周圍神經和肌肉疾病的實驗室檢查[J];實用兒科臨床雜志;2006年12期

3 李潤潔;腦性癱瘓患兒周圍神經損傷的電生理改變[J];中國臨床康復;2002年24期

4 孫薇;腦癱患者脊神經根亞顯微病變及意義[J];中華物理醫(yī)學雜志;1997年02期

5 陳哨軍,李繼海,劉敦厚;痙攣性腦癱周圍神經及骨骼肌亞顯微研究的臨床意義[J];中華小兒外科雜志;2001年03期

6 曾麗,鄭金甌,宋少霞;H反射對糖尿病神經根病的診斷作用[J];卒中與神經疾病;2003年06期

，

本文編號：1985310