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脑瘫:对249例连续患者的思考及文献综述

Cerebral Palsy. Considerations Upon 249 Consecutive Patients and Review of Literature.

作者信息

Bourgleh S, Nemeş R N, Hetaimish B, Burileanu A H, Fallatah S, Chiuţu L C

机构信息

"The First Clinic" Hospital, Jeddah, Kingdom of Saudi Arabia.

Department of Surgery, University of Medicine and Pharmacy of Craiova, Romania.

出版信息

Curr Health Sci J. 2019 Oct-Dec;45(4):405-411. doi: 10.12865/CHSJ.45.04.09. Epub 2019 Dec 30.

Abstract

AIM

to determine the prevalence of cerebral palsy (C.P.) among children and to describe its main characteristics (clinical forms, treatment plan, and results).

MATERIAL AND METHODS

249 C.P were studied (120 boys and 129 girls, aged between 0 and 12 years) during 2,321 consecutive clinic visits (incidence 10.7%) to a private pediatric orthopedic clinic in Jeddah, Saudi Arabia, between 2011 and 2016. Spastic type was the main clinical form (231=92.8%), spastic diplegia being the most frequent (166=71.9%). The treatment was complex: conservative only in 42.2%; surgery indicated in 149 (59.8%) cases was performed only in 81 cases, by means of muscle and/or bone procedures, depending on the lesion balance.

RESULTS

The postoperative results were excellent in 2.4% of cases, acceptable to some extent in 93.8% and poor in 3.8%. We registered a recurrence rate of 14.8%, a postoperative morbidity rate of 6.17% with a postoperative mortality rate of 0. Treatment results could not be assessed in 129 (51.9%) cases due to lack of follow up.

CONCLUSION

  1. C.P. represents the third most common diagnosis in pediatric orthopedic private practice. 2. The treatment results were acceptable in most cases, but not optimal. 3. Gait analysis using in the preoperative planning could improve significantly the outcome, especially in complicated cases.
摘要

目的

确定儿童脑性瘫痪(C.P.)的患病率,并描述其主要特征(临床类型、治疗方案及结果)。

材料与方法

2011年至2016年间,在沙特阿拉伯吉达一家私立儿科骨科诊所对249例脑性瘫痪患儿(120例男孩,129例女孩,年龄在0至12岁之间)进行了连续2321次门诊研究(发病率为10.7%)。痉挛型是主要临床类型(231例,占92.8%),痉挛性双侧瘫最为常见(166例,占71.9%)。治疗较为复杂:仅采用保守治疗的占42.2%;149例(59.8%)患儿需手术治疗,其中仅81例进行了手术,根据病变平衡情况采用肌肉和/或骨骼手术。

结果

术后结果中,2.4%的病例效果极佳,93.8%的病例在一定程度上可接受,3.8%的病例效果较差。复发率为14.8%,术后发病率为6.17%,术后死亡率为0。由于缺乏随访,129例(51.9%)病例的治疗结果无法评估。

结论

  1. 脑性瘫痪是儿科骨科私立诊所中第三常见的诊断。2. 大多数病例的治疗结果尚可,但并非最佳。3. 在术前规划中使用步态分析可显著改善治疗效果,尤其是在复杂病例中。
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8ad9/7014978/cf23dec479d0/CHSJ-45-4-405-fig1.jpg

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