临床小儿外科杂志2025，Vol.24Issue(2)：179-183,5.DOI:10.3760/cma.j.cn101785-202312027-013
颅缝早闭合并神经发育障碍患儿手术后康复干预效果的影响因素分析
Analysis of influencing factors for postoperative neurological functional outcomes in children with cra-niosynostosis and neurodevelopmental disorders
摘要
Abstract
Objective To explore the influencing factors for the effectiveness of postoperative rehabilita-tive interventions in children with craniosynostosis(CS)plus neurodevelopmental disorders.Methods Retro-spective analysis was conducted for the relevant clinical data of 41 CS children plus neurodevelopmental disor-ders undergoing postoperative rehabilitative interventions from September 2016 to March 2023.The influencing factors for the effectiveness of postoperative rehabilitative interventions were evaluated based upon the differenti-al scores of developmental quotient(DQ)from the first and last assessments using Gesell Developmental Schedule(GDS).They were classified into a"good efficacy group"(n=27)if DQ score difference between the first and last GDS assessments was ≥10 points and a"poor efficacy group"(n=14)if DQ score difference＜10 points.The relevant data collected for both groups included gender,age at surgery,type of CS,education level of primary caregivers,first and last GDS DQ scores,assessment age,age at the start of rehabilitative inter-vention,total duration of rehabilitation and follow-up time.The influencing factors for postoperative rehabilitation were then examined.Results Univariate analysis of two groups revealed statistically significant differences in postoperative first DQ score[44.50(18.75,62.25)vs.69.00(62.00,78.00),Z=-3.259,P=0.001],age at the start of rehabilitative intervention[28.00(17.5,36.75)vs.14.00(9.00,18.00)month,Z=-3.358,P=0.000]and total duration of rehabilitation[7.500(2.50,12.75)vs.14.00(12.00,18.00)month,Z=-2.604,P=0.008](P＜0.05).These variables were then included in multivariate Logistic regression analy-sis.The results indicated that postoperative first DQ score(OR=1.140,95％CI:1.044-1.246),age at the start of rehabilitative intervention(OR=0.919,95％CI:0.849-0.996)and total rehabilitative duration(OR=1.314,95％CI:1.016-1.698)were independent influencing factors for the effectiveness of postoperative rehabilitation.Based upon the cut-off values,comparisons of DQ score differences were made between two groups:postoperative first DQ ≥52.5 vs.＜52.5,total rehabilitative duration ≥9.5 vs.＜9.5 month and age at the start of rehabilitative intervention ≥22.5 vs.＜22.5 month.The differences were statistically significant(P＜0.05).Conclusions Group with postoperative first DQ ≥52.5 had better rehabilitative outcomes than group with DQ＜52.5.Similarly,group with total rehabilitative duration ≥9.5 month had better outcomes than group with＜9.5 month of rehabilitation and group with rehabilitation start age ≥ 22.5 month showed better outcomes than group aged＜22.5 month.The milder postoperative neurodevelopmental impairment,the earlier rehabilitative intervention,the longer rehabilitative duration and the better rehabilitative outcomes.关键词
颅缝早闭/康复干预/神经发育障碍/影响因素Key words
Craniosynostosis/Rehabilitative Intervention/Neurodevelopmental Disorders/Influencing Factors引用本文复制引用
段雅琴,吴水华,胡继红,刘娟,刘华..颅缝早闭合并神经发育障碍患儿手术后康复干预效果的影响因素分析[J].临床小儿外科杂志,2025,24(2):179-183,5.基金项目
湖南省残疾人康复科研项目(2021XK0221) （2021XK0221）
湖南省科技厅临床医学研究中心项目(2021SK4018) （2021SK4018）
湖南省自然科学基金资助项目(2025JJ50682) Disabled Rehabilitative Research Project of Hunan Province(2021XK0221) （2025JJ50682）
Hunan Provincial Department of Science and Technology-Clinical Medical Research Center Project(2021SK4018) （2021SK4018）
Supported by Hunan Provincial Natural Science Foundation of China(2025JJ50682) （2025JJ50682）
