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[姿势性斜头畸形婴儿的随访与预后研究]

[Follow-up and prognostic study of infants with positional plagiocephaly].

作者信息

Pan Wei-Wei, Liao Jiao-Jiao, Tong Xiao-Mei

机构信息

Department of Pediatrics, Peking University Third Hospital, Beijing 100191, China.

出版信息

Zhongguo Dang Dai Er Ke Za Zhi. 2023 Apr 15;25(4):368-373. doi: 10.7499/j.issn.1008-8830.2210031.

Abstract

OBJECTIVES

To study the effects of infantile positional plagiocephaly on the growth and neural development.

METHODS

A retrospective study was conducted on the medical data of 467 children who underwent craniographic examination and were followed up to 3 years of age in Peking University Third Hospital from June 2018 to May 2022. They were divided into four groups: mild positional plagiocephaly (=108), moderate positional plagiocephaly (=49), severe positional plagiocephaly (=12), and normal cranial shape (=298). The general information of the four groups and the weight, length, head circumference, visual acuity screening results, hearing test results, and the scores of Pediatric Neuropsychological Developmental Scales/Gesell Developmental Schedules of the four groups from 6 to 36 months old were compared.

RESULTS

The rates of adverse perinatal factors, congenital muscular torticollis, and supine fixed sleeping posture in the mild, moderate, and severe positional plagiocephaly groups were higher than the normal cranial group (<0.05). There was no significant difference in weight, length, and head circumference among the four groups at 6, 12, 24 and 36 months of age (>0.05). The incidence rate of abnormal vision in the severe positional plagiocephaly group was higher than that in the mild positional plagiocephaly, moderate positional plagiocephaly and normal cranial shape groups at 24 and 36 months of age (<0.05). The scores of the Pediatric Neuropsychological Developmental Scales at 12 and 24 months of age and the scores of the Gesell Developmental Schedules at 36 months of age in the severe positional plagiocephaly group were lower than those in the mild positional plagiocephaly, moderate positional plagiocephaly and normal cranial shape groups, but the difference was not statistically significant (>0.05).

CONCLUSIONS

Adverse perinatal factors, congenital muscular torticollis, and supine fixed sleeping position may be associated with infantile positional plagiocephaly. Mild or moderate positional plagiocephaly has no significant impact on the growth and neural development of children. Severe positional plagiocephaly have adverse effects on the visual acuity. However, it is not considered that severe positional plagiocephaly can affect the neurological development.

摘要

目的

研究婴儿体位性斜头畸形对生长发育及神经发育的影响。

方法

对2018年6月至2022年5月在北京大学第三医院接受颅骨X线检查并随访至3岁的467例儿童的医学资料进行回顾性研究。将其分为四组:轻度体位性斜头畸形组(n = 108)、中度体位性斜头畸形组(n = 49)、重度体位性斜头畸形组(n = 12)和正常头型组(n = 298)。比较四组的一般资料以及四组6至36月龄时的体重、身长、头围、视力筛查结果、听力测试结果和小儿神经心理发育量表/格塞尔发育量表评分。

结果

轻度、中度和重度体位性斜头畸形组的围生期不良因素、先天性肌性斜颈及仰卧位固定睡眠姿势的发生率均高于正常头型组(P<0.05)。四组在6、12、24和36月龄时的体重、身长和头围差异无统计学意义(P>0.05)。重度体位性斜头畸形组在24和36月龄时的视力异常发生率高于轻度体位性斜头畸形组、中度体位性斜头畸形组和正常头型组(P<0.05)。重度体位性斜头畸形组在12和24月龄时的小儿神经心理发育量表评分以及36月龄时的格塞尔发育量表评分低于轻度体位性斜头畸形组、中度体位性斜头畸形组和正常头型组,但差异无统计学意义(P>0.05)。

结论

围生期不良因素、先天性肌性斜颈及仰卧位固定睡眠姿势可能与婴儿体位性斜头畸形有关。轻度或中度体位性斜头畸形对儿童的生长发育及神经发育无明显影响。重度体位性斜头畸形对视敏度有不良影响。然而,目前认为重度体位性斜头畸形不会影响神经发育。

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