CAJ | 학술논문

目的：探讨颈总动脉周围交感神经网剥脱切除术治疗脑性瘫痪( CP )患儿的临床效果及对其认知功能的影响作用。方法采用回顾性研究的方法，纳入新乡医学院第三附属医院脑科疾病中心2008年7月至2014年8月收治的学龄前CP患儿69例。其中采用颈总动脉周围交感神经网剥脱切除术治疗43例(手术组)，拒绝采用手术治疗患儿26例(未手术组)。检测并比较2组患儿治疗前与治疗6个月的肌张力改善、运动能力改善情况，并测定2组患儿治疗前、治疗6个月的发育商( DQ)、智商( IQ)、双侧大脑中动脉( MCA)血流动力学指标差异。结果治疗6个月后，手术组患儿的肌张力评分[(2.2±1.1)分]、步行能力评分[(3.5±0.7)分]均显著优于未手术组[(4.5±0.6)分、(2.7±0.8)分](P均<0.05)，同时较治疗前[(4.8±0.6)分、(2.2±0.9)分]显著改善(P均<0.05)。治疗6个月后，手术组患儿IQ评分、大动作、精细动作、社会适应、个人社交、语言评分及MCA的平均流速( MV)、峰值流速( PV)、阻力指数( RI)、搏动指数( PI)测定值显著高于未手术组，同时较治疗前显著改善(P均<0.05)。结论颈总动脉周围交感神经网剥脱切除术治疗CP患儿具有较好的临床效果，同时能够显著改善患儿的认知功能。
목적：탐토경총동맥주위교감신경망박탈절제술치료뇌성탄탄( CP )환인적림상효과급대기인지공능적영향작용。방법채용회고성연구적방법，납입신향의학원제삼부속의원뇌과질병중심2008년7월지2014년8월수치적학령전CP환인69례。기중채용경총동맥주위교감신경망박탈절제술치료43례(수술조)，거절채용수술치료환인26례(미수술조)。검측병비교2조환인치료전여치료6개월적기장력개선、운동능력개선정황，병측정2조환인치료전、치료6개월적발육상( DQ)、지상( IQ)、쌍측대뇌중동맥( MCA)혈류동역학지표차이。결과치료6개월후，수술조환인적기장력평분[(2.2±1.1)분]、보행능력평분[(3.5±0.7)분]균현저우우미수술조[(4.5±0.6)분、(2.7±0.8)분](P균<0.05)，동시교치료전[(4.8±0.6)분、(2.2±0.9)분]현저개선(P균<0.05)。치료6개월후，수술조환인IQ평분、대동작、정세동작、사회괄응、개인사교、어언평분급MCA적평균류속( MV)、봉치류속( PV)、조력지수( RI)、박동지수( PI)측정치현저고우미수술조，동시교치료전현저개선(P균<0.05)。결론경총동맥주위교감신경망박탈절제술치료CP환인구유교호적림상효과，동시능구현저개선환인적인지공능。
Objective To explore the clinical effect of excision of peripheral sympathetic nerve network in common carotid artery on children with cerebral palsy (CP)and the effect on their cognitive function. Methods A ret-rospective study method was admitted to preschool children with CP in 69 cases in Center of Brain Disease,the Third Hospital Affiliated to Xinxiang Medical University from July 2008 to August 2014, the common carotid artery sympathetic with the surrounding network stripping off resection treatment of 43 cases ( surgery group) ,without the use of surgery in the treatment of children with 26 cases ( no operation group) . The muscle tension improved, movement to improve the ability of 2 groups before and after treatment 6 months were detected and compared. Developmental quotient ( DQ) ,intelligence quotient ( IQ) ,bilateral middle cerebral artery ( MCA) hemodynamic index difference were deter-mined between 2 groups before and after treatment 6 months. Results After treatment 6 months,the muscle tension score and walking ability score of the surgery group were significantly better than those of no operation group [(2. 2± 1. 1) scores vs (4. 5±0. 6)scores,(3. 5±0. 7) scores vs (2. 7±0. 8) scores,all P<0. 05],and significantly improved compared with before treatment[(4. 8±0. 6)scores,(2. 2±0. 9)scores,all P<0. 05]. After treatment 6 months,the IQ score,fine motor, social adaptation, personal social, language score and MCA mean velocity ( MV ) , peak velocity ( PV) ,resistance index ( RI) ,pulsatility index ( PI) determination value of the surgery group were significantly higher than those of no operation group and before treatment (all P<0. 05). Conclusions Excision of peripheral sympathetic nerve network on common carotid artery has a good clinical effect in the treatment of CP , and can significantly improve the cognitive function of children with CP .