颈动静脉周围交感神经网切除治疗脑瘫的临床研究(附30例)

目的:探讨通过颈动静脉周围交感神经网切除治疗脑瘫的疗效,评估对有智商、流涎、语言及肢体功能障碍术后改善情况。方法:30例手足徐动型、共济失调型和混合型脑瘫患者,行颈动静脉周围交感神经网切除术,术后进行系统性康复治疗。随访半年,进行疗效评估。同时采用经颅多普勒(TCD)观察术前及术后1周颅内血流变化,对脑血流改变情况进行动态观察分析;对脑瘫患儿的智商、流涎、语言及肢体功能进行术前术后对比。结果:颈动静脉周围交感神经网切除术后较术前大脑中动脉血液流速加快,血流量增加。30例中,显效20例,有效9例,好转1例,无效0例。流涎停止18例,减轻12例,无效0例。26例发音障碍患者,改善17例,有效率65.3%。1 1例术前智商仅40%～50%,术后8例反应度有不同程度提高,占72.7%。30例术后四肢痉挛明显减轻。结论:颈动静脉周围交感神经网切除术可以增加脑血流量,减轻肢体痉挛,促进智商的提高,可以抑止或减少流涎,改善患者功能,提高生活质量。

Clinical Research Arteriovenous around the Neck for treatment of Cerebral Plsy Sympathetic Network of (of 30 cases)

Objective:To through the neck of arteriov.enous sympathetic network around the remcacy for the resection teatment of cerebral paly,discuss the intelligence assessment,drooling,language and dysfunction after improving the situatio.Methods:30 cases of hand,foot-acting, ataxia and mixed with cerebral palsy.was performed around the Ineck arteriovenous sympathetic network resection,after a systematic rehabilitation treatment.Follow-up six months,to assess the effects.At the same time using transcranial Doppler(TCD)observed before and after a week of cerebral blood flow in the cerebral blood flow changes in the observation of dynamic analysis of the IQ of children with cerebral palsy,drooling,language and physical features of Before and after comparison.Results:Artefiovenous around the neck after a sympathetic network of the former middle cerebral arteryblood flow rate accelerated,blood flow volume increased.30 cases,20 cases markedly effective,efficient nine cases,one case of improvement,invalid 0 cases.1 8 cases to stop drooling,reduce the1 2 cases,invalid 0 cases.See also 26 cases of patients with barriers,improve the 1 7 cases,theefficiency of 65.3 percent.1 1 cases before the IQ of only 40%~50%,after eight cases have differentreactions of the increase.accounting for 72.7 percent.30 cases after the limbs spasm reducedsignificantly.Conclusion:Arteriovenous around the neck resection of sympathetic network increase cerebral blood flow and reduce body spasm,and promote the improvement of intelligenc restrain or reduce the drooling,improve patient function,improve the quality of life.