Bringas-Grande A, Fernández-Luque A, García-Alfaro C, Barrera-Chacón M, Toledo-González M, Domínguez-Roldá J M
Rehabilitación y Medicina Física, Hospital de Rehabilitación y Traumatología, Hospital Universitario Virgen del Rocio, Sevilla, España.
Rev Neurol. 2002;35(9):812-7.
To know the etiological factors of cerebral palsy (CP) incident during pregnancy and neonatal/perinatal periods. To know evolution of a child with a CP diagnosis.
PATIENTS, MATERIAL AND METHODS: Bibliographical review of paediatric and rehabilitation texts and databases in Internet. Elaboration of a data collecting questionnaire for reviewing clinical records of patients treated in Paediatric Rehabilitation between 1996 and 2000.
250 patients records reviewed. Most frequent illnesses during pregnancy: first twelve weeks haemorrhages: 17.9% and diabetes 8.4%. Child birth: preterm births 32%, cephalic presentation 78.8%, caesarean operations 32%. Mean birth weight 2,714 g, low birth weight babies 27.2%. Needed hospitalary treatment 48%. Mean time in incubator: 46 days among preterm and 26.6 among full term. Mean time in intensive care units: 44.4 days among preterm and 22.7 among full term. Associated diagnoses: CRP 8%, birth asphyxia 24%, neonatal jaundice 27.2%, neonatal respiratory distress 24%, neonatal sepsis 10%, congenital cardiological illnesses 2.4%, dismorphia 2.4%, epilepsy in 40%. Diagnostic imaging: atrophy 38.8%, hydrocephalus 29.4%, ischemia 14.9%, haemorrhage 11.6%. No findings in 23.8%. Children were sent to Paediatric Rehabilitation at mean age of 8 months. Most frequent disorders: spastic quadriplegia (36.1%) spastic diplegia (26.5%) and hemiplegia (17%). Mental retardation 55%. School attendance 81.2%. CP postnatal in 5.2%.
Incidence of CP (2.5/1,000 alive new born) hardly avoidable for persistent rates of prematurity and complications in child births. Good quality of life and survival until adult ages.
了解孕期及新生儿期/围生期脑瘫（CP）发病的病因。了解脑瘫患儿的病情发展。
患者、材料与方法：对儿科及康复教材以及互联网数据库进行文献综述。编制一份数据收集问卷，用于回顾1996年至2000年期间在儿科康复科接受治疗的患者的临床记录。
共查阅了250份患者记录。孕期最常见的疾病：孕早期12周内出血占17.9%，糖尿病占8.4%。分娩情况：早产占32%，头位分娩占78.8%，剖宫产占32%。平均出生体重2714克，低体重儿占27.2%。需要住院治疗的占48%。早产儿平均在暖箱中的时间为46天，足月儿为26.6天。在重症监护病房的平均时间：早产儿为44.4天，足月儿为22.7天。相关诊断：CRP占8%，出生窒息占24%，新生儿黄疸占27.2%，新生儿呼吸窘迫占24%，新生儿败血症占10%，先天性心脏病占2.4%，畸形占2.4%，癫痫占40%。诊断性影像学检查结果：萎缩占38.8%，脑积水占29.4%，缺血占14.9%，出血占11.6%。23.8%未发现异常。患儿平均8个月时被送往儿科康复科。最常见的障碍：痉挛性四肢瘫（36.1%）、痉挛性双瘫（26.5%）和偏瘫（17%）。智力低下占55%。上学率为81.2%。出生后发生脑瘫的占5.2%。
由于早产率和分娩并发症持续存在，脑瘫发病率（每1000例活产新生儿中有2.5例）几乎难以避免。生活质量良好，可存活至成年。
