临床小儿外科杂志2016，Vol.15Issue(6)：551-557,7.DOI:10.3969/j.issn.1671-6353.2016.06.009
婴儿先天性肌性斜颈保守综合治疗1142例
Comprehensive treatment of infants with congenital muscular torticollis:a report of 1142 cases
摘要
Abstract
Objective To explore the comprehensive treatment outcomes of infants with congenital mus-cular torticollis (CMT)and analyze the influencing factors of its efficacy for optimized treatment. Methods A total of 1 ,1 42 infants were initially diagnosed as CMT.According to medical history,clinical signs and neck ultrasonography,they were divided into lump and ultrasound groups.The lump group included patients with a history of lump occurrence,palpable lump and ultrasonic sternocleidomastoid thickening or lump.And the ultrasound group included those without a history of lump occurrence,uncertain palpation lump yet ultrasonic sternocleidomastoid thickening.All patients received standard outpatient measures of manual stretching,lump massage and short-wave ultrasonic physiotherapy.Also local glucocorticoid injection was provided for sternoclei-domastoid tumor.The follow-up period was at least 1 year and regular follow-up results were also analyzed ac-cording to the relevant factors.Curative efficacy was assessed after treatment. Results The curative ratio of comprehensive treatment was 90.97% and only 1 03 (9.03%)cases were operated.Follow-ups of 1 1 42 (83.2%)cases showed that 988 (86.5%)cases fared excellent&good,51 (3.1%)fair and 1 03 (1 0.4%) poor.Statistical analysis showed that:a ) significant relevance existed between curative efficacy and such factors as lump (P=0.049),give-way(P<0.001 ),initial diagnosis age (P<0.001 ),rotation deficit (P<0.001 )and gender(P=0.038);b)Patients with sudden giving-way or snapping of sternomastoid was signifi-cantly associated with initial diagnosis age(P<0.001 )and dystocia(P=0.01 1 );c)Patients treated by glu-cocorticoid injection were significantly associated with initial diagnosis age(P<0.001 ),rotation deficit(P<0.001),male(P=0.018),left sideness(P<0.001),fetal malposition (P=0.029)and eutocia(P=0.024);d)Treatment duration was associated with lumps(P<0.001 ),give-way(P<0.001 ),initial diagno-sis age(P<0.001 ),rotation deficit (P<0.001 )and premature delivery (P=0.026);e)Treatment duration of patients with fair and poor efficacy was longer than those with excellent or good efficacy(P=0.009);f)Op-erative patients were associated with lumps(P=0.044),give-way (P=0.005),initial diagnosis age (P<0.001 )and rotation deficit (P<0.001 ). Conclusions Along with manual stretching,lump massage,ultra-sonic physiotherapy and localized glucocorticoid injection (if necessary),comprehensive treatment is both safe and efficacious for CMT infants.关键词
斜颈/先天性/综合疗法/婴儿Key words
Torticollis/CN/Combined Modality Therapy/Infant引用本文复制引用
赵章帅,唐盛平,熊竹..婴儿先天性肌性斜颈保守综合治疗1142例[J].临床小儿外科杂志,2016,15(6):551-557,7.基金项目
本研究由深圳市科学创新委员会资助项目 （）
