Motor development of children born prematurely with perinatal hypoxic-ischemic damages of the central nervous system

O. Vareshniuk
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Abstract

A comprehensive examination of 79 children of middle age (3,2±1,3) years old with perinatal hypoxic-ischemic damage to the central nervous system who were born prematurely was performed. The clinical features of impaired motor functions in premature infants who underwent perinatal hypoxic-ischemic brain damage complicated by intraventricular hemorrhages were studied. It was shown that cerebral palsy was diagnosed in 20,3 % of sick children, which was accompanied by severe motor disorders of levels IV–V according to the classification of motor functions GMFCS; 37,9 % have spastic diplegia with II–III level of motor disorders; 27,8 % have a hemiplegic form of cerebral palsy with motor disorders corresponding to level II of the GMFCS classification. Acquired posthemorrhagic hydrocephalus was diagnosed in 14,0 % of the examined children, while the vast majority of children who were operated on before 6 months of age did not have motor deficiency (level III according to the GMFCS classification); 1 child (9,1 %) was not operated on and had a V level of motor disorders according to GMFCS. It has been established that the most significant factors that form a severe motor prognosis are: gestational age of 27–30 weeks, peri-intraventricular hemorrhages of II–IV degrees, periventricular leukomalacia of III degree and signs of periventricular ischemia.
围产期缺氧缺血性中枢神经系统损伤早产儿的运动发育
对79例早产儿(3,2±1,3)岁围生期中枢神经系统缺氧缺血性损伤患儿进行了综合检查。研究围生期缺氧缺血性脑损伤并发脑室内出血的早产儿运动功能受损的临床特点。结果表明:脑瘫患儿占20.3%,并伴有严重的运动功能障碍(按GMFCS分类为IV-V级);37.9%为痉挛性双瘫伴II-III级运动障碍;27.8%的患者有偏瘫形式的脑瘫伴运动障碍,符合GMFCS分级的II级。在接受检查的儿童中,14.0%被诊断为获得性出血性脑积水,而绝大多数在6个月前接受手术的儿童没有运动缺陷(根据GMFCS分类为III级);1例患儿(9.1%)未手术,GMFCS评分为V级运动障碍。已经确定,形成严重运动预后的最重要因素是:胎龄27-30周,II-IV度脑室周围出血,III度脑室周围白质软化和脑室周围缺血的迹象。
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