早产儿神经发育特点及临床诊疗进展

随着医疗水平的进步,早产儿的存活率不断增加,但幸存的早产儿因各器官系统发育不完善,更易受到外界不良因素的影响,所面临的各种生后并发症的风险更大,特别是神经发育损伤,如脑性瘫痪、认知障碍、自闭症及执行功能障碍等,给家庭、社会及卫生系统带来沉重的负担。本文通过对早产儿神经发育特点、神经发育评估方法以及早期干预措施进行系统综述,为临床早期准确识别有神经系统损伤的早产儿、并对不同早产儿进行个体化的早期干预训练提供依据,以期改善早产儿的预后。     

癫痫患儿与正常儿童气质的差异性研究

目的探讨癫痫患儿与正常儿童气质的差别。方法随机入选2007-2008年我院儿科确诊的42名癫痫患儿及56名非癫痫正常儿童,进行气质测定。结果（1）癫疴组与正常儿童组气质类型分布存在显著性差异（χ2=6．417,P=0．040）;（2）癫痫患儿在活动水平、节律性、适应性、坚持性、情绪本质等气质维度的得分比正常儿童高,且具有统计学差异（P〈0．05）。结论癫痫疾病对儿童的气质特点具有显著的影响,使患儿的气质偏向消极。     

针刺结合运动疗法治疗小儿脑性瘫痪粗大运动功能的疗效

目的观察针刺结合运动疗法对脑性瘫痪(CP)患儿粗大运动功能的影响。方法将60例CP患儿按年龄、临床表现和诊断分型进行近似配对分为对照组和观察组,每组30例。观察组患儿采用针刺配合运动疗法治疗,对照组患儿只采用运动疗法。治疗4个月后用粗大运动功能评定量表(GMFM-88)进行疗效比较。结果 2组患儿治疗后GMFM-88总百分比显著高于治疗前(P<0.01)。观察组患儿GMFM-88改善值和反映坐位、站立的能区(B区、D区)百分比均显著高于对照组(P<0.01)。结论针刺结合运动疗法可以显著改善CP患儿的粗大运动功能,疗效高于单纯运动疗法,尤其在改善患儿坐和站能力方面更有效。     

MRI在EV71病毒诱发的手足口病并发脑干脑炎的诊断价值

摘要目的探讨MRI在EV71病毒诱发的手足口病合并脑干脑炎的诊断价值及其影像学特点。方法选择46例重症手足口病（HFMD）患儿,所有患儿治疗前及治疗后3个月均行头颅MRI及病原学检查,对结果进行对比分析。结果入院时,有32例患儿MRI检测结果显示为有异常（69．6％）,EV71病原学的检山率为100％,3个月斤,MRI检测结果显示均正常,病原中检出率为8．7％,两组数据较入院时均明显降低（P〈O．05）。结论MRI是既安全义无损的影像学检查方法,在早期诊断HFMD合丌神经系统病变的准确率较高,可以为临床提供较早的参考依据。     

热性惊厥患儿血清褪黑素水平和细胞免疫功能的变化及其临床意义

Objective To investigate the changes of melatonin and cellular immunological function in children with febrile seizures and its clinical significance. Methods 50 children, including 23 cases with complex febrile seizure (CFS) and 27 cases with simple febrile seizure (SFS) , and 25 cases with upper respiratory infections children selected as control group were enrolled in this study. Serum melato- nin was measured by enzyme-linked immunosorbent assay (ELISA) and cellular immunological function was measured by flow eytomcter. Results The levels of serum melatonin in the 3 groups of CFS, SFS, control were(14. 91±2. 61) ng/L, (20. 72±2. 54) ng/L, (23.93± 2. Ol) ng/L, respectively. The melatonin levels in CFS children were significantly decreased than that in control group and SFS children (P <0. O1). CD3 + ,CD4 +, the ratio of CD4 + /CD8 + and CD8 + in CFS group were significantly decreased than that in control group and SFS group (P <0.01). The ratio of CD4 +/CD8 + in SFS group was significantly decreased than that in control group (P <0.05), but CD3 + ,CD4 + and CD8 + had no statistics significance among these groups(P >0. 05). The serum rnelatonin level were positive related withdecreaseddegreeofCD3+,CD4+ andtberatioofCD4+ /CDS+ (r≥0. 472, P <0.05). Conclusion The disorder cfcellular immunological function was possible related with the loss of serum melatonin, and the loss of serum melatonin maybe one of the reasons for febrile seizures relapse and brain injured.     

热性惊厥患儿血清褪黑素水平和细胞免疫功能的变化及其临床意义

Objective To investigate the changes of melatonin and cellular immunological function in children with febrile seizures and its clinical significance. Methods 50 children, including 23 cases with complex febrile seizure (CFS) and 27 cases with simple febrile seizure (SFS) , and 25 cases with upper respiratory infections children selected as control group were enrolled in this study. Serum melato- nin was measured by enzyme-linked immunosorbent assay (ELISA) and cellular immunological function was measured by flow eytomcter. Results The levels of serum melatonin in the 3 groups of CFS, SFS, control were(14. 91±2. 61) ng/L, (20. 72±2. 54) ng/L, (23.93± 2. Ol) ng/L, respectively. The melatonin levels in CFS children were significantly decreased than that in control group and SFS children (P <0. O1). CD3 + ,CD4 +, the ratio of CD4 + /CD8 + and CD8 + in CFS group were significantly decreased than that in control group and SFS group (P <0.01). The ratio of CD4 +/CD8 + in SFS group was significantly decreased than that in control group (P <0.05), but CD3 + ,CD4 + and CD8 + had no statistics significance among these groups(P >0. 05). The serum rnelatonin level were positive related withdecreaseddegreeofCD3+,CD4+ andtberatioofCD4+ /CDS+ (r≥0. 472, P <0.05). Conclusion The disorder cfcellular immunological function was possible related with the loss of serum melatonin, and the loss of serum melatonin maybe one of the reasons for febrile seizures relapse and brain injured.