Stein S C, Schut L, Ames M D
Dev Med Child Neurol. 1975 Jun;17(3):311-9. doi: 10.1111/j.1469-8749.1975.tb04668.x.
In an attempt to formulate a procedure for the selection of those children with open myelomeningocele most likely to benefit from early surgery, the records of 163 children have been reviewed. No physical findings, either singly or in combination, were found to distinguish accurately between children with good and poor prognoses, and an alternative selection procedure is proposed which takes into consideration the absence or presence of lacunar skull deformity (a finding strongly associated with mental retardation). Early surgery is not recommended for children with lacunar skull deformity and at least two of Lorber's major adverse neonatal criteria, or children with associated gross congenital anomalies. This selection procedure has been applied retrospectively to the 163 children reviewed and has been shown to predict the (known) outcome of these children much more reliably than existing selection criteria.
为了制定一种程序，以挑选出那些最有可能从早期手术中获益的开放性脊髓脊膜膨出患儿，我们回顾了163名患儿的病历。未发现单独或综合的体格检查结果能够准确区分预后良好和预后不良的患儿，因此提出了一种替代选择程序，该程序考虑了是否存在颅骨缺损畸形（这一发现与智力发育迟缓密切相关）。对于有颅骨缺损畸形且至少符合洛伯（Lorber）两项主要不良新生儿标准的患儿，或伴有严重先天性畸形的患儿，不建议进行早期手术。此选择程序已回顾性应用于所审查的163名患儿，结果表明，与现有选择标准相比，它能更可靠地预测这些患儿（已知的）预后。
