CAJ | 학술논문

目的：通过丹佛发育筛查(DDST)分析不同程度及宫内转归类型的孤立性侧脑室扩张(IV)患儿生后0~6岁的智能发育情况。方法选择2007年1月1日至2013年1月1日于济宁医学院附属医院就诊的186例 IV 患儿为研究对象,并纳入研究组(n=186),再根据 IV 诊断标准将其进一步分为轻度扩张型 IV 亚组(n=159)、中度扩张型 IV 亚组(n=18)和重度扩张型 IV 亚组(n=9)。选择同期于本院行常规体检的200例正常婴幼儿为对照组(n=200)。两组儿童在排除影响发育的高危因素后,均进行 DDST,将不同程度及宫内转归类型的研究组患儿分别与对照组儿童进行比较,并研究 DDST 结果可疑或异常发生率与患儿年龄的关系。结果①研究组 DDST 结果示异常和可疑的患儿分别为8例(4.3%)和 16例(8.6%),对照组分别为0和4例(0.2%),两组比较,差异有统计学意义(χ2=95.69,P <0.05)。②轻度扩张 IV 亚组的进展型、中度扩张 IV 亚组的进展型和稳定型、重度扩张 IV 亚组的3种类型患儿 DDST 结果分别与对照组比较,差异均有统计学意义(χ2=15.99,20.61,35.16,27.56,14.41,9.35；P <0.05)。③研究组 DDST 结果示异常和可疑发生率与患儿年龄增加呈正相关关系(χ2= 154.30,159.09；P <0.05)。④研究组 DDST 结果示异常及可疑的24例患儿中,智能发育障碍表现依次为言语障碍(54.2%)、粗大运动发育障碍(41.6%)、精细动作发育障碍(33.3%)和个人与社会(16.7%)。结论轻度扩张 IV 的进展型、中度扩张 IV 的进展型和稳定型、重度扩张 IV 的3种类型均可能导致 IV 患儿智能发育障碍,并且患儿智能发育障碍发生率可随其年龄增加而增高。对于早期未发现异常的 IV 高危儿应重视远期随访,尤其注意其言语和运动能发育情况。
목적：통과단불발육사사(DDST)분석불동정도급궁내전귀류형적고립성측뇌실확장(IV)환인생후0~6세적지능발육정황。방법선택2007년1월1일지2013년1월1일우제저의학원부속의원취진적186례 IV 환인위연구대상,병납입연구조(n=186),재근거 IV 진단표준장기진일보분위경도확장형 IV 아조(n=159)、중도확장형 IV 아조(n=18)화중도확장형 IV 아조(n=9)。선택동기우본원행상규체검적200례정상영유인위대조조(n=200)。량조인동재배제영향발육적고위인소후,균진행 DDST,장불동정도급궁내전귀류형적연구조환인분별여대조조인동진행비교,병연구 DDST 결과가의혹이상발생솔여환인년령적관계。결과①연구조 DDST 결과시이상화가의적환인분별위8례(4.3%)화 16례(8.6%),대조조분별위0화4례(0.2%),량조비교,차이유통계학의의(χ2=95.69,P <0.05)。②경도확장 IV 아조적진전형、중도확장 IV 아조적진전형화은정형、중도확장 IV 아조적3충류형환인 DDST 결과분별여대조조비교,차이균유통계학의의(χ2=15.99,20.61,35.16,27.56,14.41,9.35；P <0.05)。③연구조 DDST 결과시이상화가의발생솔여환인년령증가정정상관관계(χ2= 154.30,159.09；P <0.05)。④연구조 DDST 결과시이상급가의적24례환인중,지능발육장애표현의차위언어장애(54.2%)、조대운동발육장애(41.6%)、정세동작발육장애(33.3%)화개인여사회(16.7%)。결론경도확장 IV 적진전형、중도확장 IV 적진전형화은정형、중도확장 IV 적3충류형균가능도치 IV 환인지능발육장애,병차환인지능발육장애발생솔가수기년령증가이증고。대우조기미발현이상적 IV 고위인응중시원기수방,우기주의기언어화운동능발육정황。
Objective To investigate the intelligential development of 0-6 year-old children with different degrees and prognosis of isolated ventriculomegaly (IV)by Denver development screening test (DDST).Methods From 1st January 2007 to 1st January 2013,a total of 186 children with IV were selected as research group (n = 186 )in Affiliated Hospital of Jining Medical College.According to IV diagnostic criteria,they were further divided into mild IV subgroup (n=1 59),moderate IV subgroup (n=18)and severe IV subgroup (n=9).Meanwhile 200 normal children at the same hospital were chosen as the control group(n = 200 ).The DDST results were compared between every subgroup and control group, respectively.And the relationship between abnormal and suspicious DDST results of children with IV and their age were observed.Results ①The DDST results showed that there were 8 abnormal cases (4.3%) and 1 6 suspicious cases (8.6%)in research group,0 abnormal case and 4 suspicious cases (0.2%)in control group,and the difference had statistical significance between two groups (χ2 = 95.69,P < 0.05 ).② The results of progressive type of mild IV subgroup,progressive and stable types of moderate IV subgroup and the three types of severe IV subgroup were respectively compared with the control group and all the differences were significant (χ2 =1 5.99,20.61,35.1 6,27.56,14.41,9.35;P <0.05).③The incidence rates of abnormal and suspicious DDST results in research group were significantly correlated with their age(χ2 =1 54.30,1 59.09;P <0.05 ).④ The intelligent developmental disorders of 24 children with abnormal and suspicious DDST results were as follow:speech disorder (54.2%),large motor development disorder (41.6%),fine movement disorder (33.3%)and personal and social disorder (1 6.7%).Conclusions The progressive type of mild IV,progressive and stable types of moderate dilatation,three types of severe dilatation,can lead to mental retardation.The proportion of mental retardation increases along with IV patients′age.Infants with high risk who are not found abnormal early need long-term follow-up,especially in the aspect of words and movement ability.