摘要
Abstract
Objective To investigate the precipitating factors, clinical features and brain magnetic resonance imaging (MRI) of cerebral palsy in children with neonatal bilirubin-encephalopathy. Methods The children with cerebral palsy associated with bilirubin-encephalopathy, who had been treated between January 1999 and June 2008 in Qingdao Rehabilitation Center for Disabled Children, were retrospectively studied. Their parents were interviewed for their high risk factors, neonatal jaundice status and development history. Two neuro-pediatricians performed together a comprehensive neurologic assessment for each patient, including physical examination, auditory brainstem respose(ABR) , brain CT/MRI , and Gesell development scales. Results All the 35 cases (female 10, male 25, ranging from six months to nine years and two months) showed involuntary motor pattern associated with dyskinestic cerebral palsy, 16 cases with dental dysplasia, six accompanied by bilateral hearing impairment and their hearing threshold measured by ABR from 75 dB to 105dB, one with West syndrome. Among the 35 children, 22 cases were admitted due to "kernicterus" and "bilirubin-encephalopathy" during neonatal period with etiological diagnosis mainly as ABO hemocytolysis or infection. Intervention time of hyperbilirubinemia was from 2 days to 1 month (the median seven days)after birth with TSB ranging from 400~ 889.9 μmol/L(the median 580 μmol/L). Ten cases had accepted exchange transfusion, the others accepted phototherapy, albumin infusion and Yin-zhi-huang peros. The other 14 cases hadn't seen doctors or been treated during neonatal period. Conclusion Our series indicate that the parents and elementary medical staff are still not aware enough of the importance of neonatal jaundice, which results in the delayed diagnosis and treatment of hyperbilirubi-naemia.How to do a good job in primary and secondary prevention of bilirubin-encephalopathy and to avoid the occur-
rence of related cerebral palsy is a critical problem we should solve.关键词
脑性瘫痪/胆红素脑病/核黄疸/核磁共振成像/促发因素Key words
cerebral palsy/bilirubin-encephalopathy/kernicterus/MRI/precipitating factor分类
医药卫生
