脑瘫患者全口康复的麻醉和康复考虑:一个病例系列

V. Bhatnagar
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引用次数: 0

摘要

脑瘫是一种中枢神经系统疾病,是由于发育中的大脑受到损伤而引起的,通常发生在围产期。病因可能是多因素的,如脑发育不良、围产期中风、产前感染、遗传性疾病、宫内缺血性损伤或早产、嗜血栓性疾病、致畸暴露、多胎妊娠、产妇发热、接触毒素、腹部创伤、脑结构畸形、胎儿畸形、器械分娩、高胆红素血症、脑膜炎、慢性肺病、摇晃婴儿综合征等都是可能的病因。患有CP的儿童由于口腔卫生不良、摄入软性饮食、咀嚼和吞咽困难以及增加使用含糖口服药物,出现早期儿童龋齿(ECC)等口腔症状的风险更高。由于相关的智力迟钝引起的行为挑战需要在全身麻醉(GA)下进行药物管理,我们提出了一系列成功管理5例被诊断为CP的儿童严重ECC的病例,并在全身麻醉下进行全口康复。其目的是强调咨询、患者术前准备、手术方式和术后康复的重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Anaesthesia and Rehabilitative Considerations for Full Mouth Rehabilitation of Cerebral Palsy Patients: A Case Series
Cerebral Palsy (CP) is a central nervous system disorder which is caused due to damage to the developing brain usually occurring in perinatal period. There could be multifactorial etiology with various factors such as maldevelopment of the brain, perinatal stroke, prenatal infection, genetic disorder, ischemic insult in utero or prematurity, thrombophilic disorders, teratogenic exposures, multiple gestations ,maternal fever, exposure to toxins, abdominal trauma, malformation of brain structures, abnormal fetal presentation, instrument delivery, hyperbilirubinemia, meningitis, chronic lung disease, shaken baby syndrome as the possible causes. The children inflicted with CP are at a higher risk for developing oral manifestations such as Early Childhood Caries (ECC) due to poor oral hygiene, intake of soft diet, difficulty in chewing and swallowing and increased use of sugary oral medications. Behavioural challenges due to associated mental retardation demands pharmacological management under General Anaesthesia (GA) and we present a case series of successful management of Severe ECC in five children diagnosed with CP managed with full mouth rehabilitation under GA. The aim is to highlight importance of counselling, preoperative preparation of patients, surgical modalities and postoperative rehabilitation.
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