Naletilić Mladenka, Tomić Vajdana, Sabić Marina, Vlak Tonko
School of Medicine, University of Mostar, Mostar, Bosnia and Herzegovina.
Coll Antropol. 2009 Dec;33 Suppl 2:59-65.
Early diagnosis and intervention intensity were suggested to be crucial factor in cerebral palsy (CP) treatment. Herein we observed 347 children diagnosed for CP in Clinical Hospital Mostar, Bosnia and Herzegovina, and studied the relationship between (a) intervention start point and the final motor outcome, (b) intensity of treatment and final outcome, and (c) relationship between documented risk factors and early diagnosis of the CP. Our study suggests that it is possible to relatively accurately diagnose the CP in the first trimester. Previous miscarriages, sepsis and intracerebral haemorrhage were significantly related to early diagnosis, while delivery outcome, RDS, premature birth, intracerebral haemorrhage, sepsis, meningitis, hydrocephalus and convulsions were found as significantly related to final motor CP outcome. We have found no significant influence of the intervention intensity and final diagnosis. Our results support the idea that the intervention start point has to be considered as one of the most important factors for the effective intervention program. In future studies dealing with the CP interventions and risk factors, special attention should be paid to homogeneity and size of the sample, as well as necessity of including the non-treated controls in the investigation.
早期诊断和干预强度被认为是脑瘫（CP）治疗的关键因素。在此，我们观察了波斯尼亚和黑塞哥维那莫斯塔尔临床医院诊断为CP的347名儿童，并研究了以下关系：（a）干预起始点与最终运动结局之间的关系；（b）治疗强度与最终结局之间的关系；（c）记录的风险因素与CP早期诊断之间的关系。我们的研究表明，在孕早期有可能相对准确地诊断出CP。既往流产、败血症和脑出血与早期诊断显著相关，而分娩结局、呼吸窘迫综合征（RDS）、早产、脑出血、败血症、脑膜炎、脑积水和惊厥被发现与CP最终运动结局显著相关。我们发现干预强度对最终诊断没有显著影响。我们的结果支持这样一种观点，即干预起始点必须被视为有效干预计划的最重要因素之一。在未来关于CP干预和风险因素的研究中，应特别关注样本的同质性和规模，以及在调查中纳入未接受治疗的对照组的必要性。
