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睡姿矫正法治疗婴儿姿势性斜头疗效观察
武燕, 吴至凤, 张雨平, 赵聪敏, 余秀梅, 杨望, 陈再新, 潘秋名
中国当代儿科杂志 ›› 2017, Vol. 19 ›› Issue (6) : 688-692.
PDF(1438 KB)
PDF(1438 KB)
睡姿矫正法治疗婴儿姿势性斜头疗效观察
Efficacy of sleep position correction for treating infants with positional plagiocephaly
目的 研究2个月疗程的睡姿矫正法对8月龄前婴儿姿势性斜头转归的影响。方法 选取2015年1月至2016年6月就诊的姿势性斜头患儿73例为研究对象，按家长意愿分成治疗组（n=46）和对照组（n=27）。治疗组采用睡姿矫正法矫正斜头；对照组予安曲婴儿正姿床垫矫正斜头。测量并计算两组患儿治疗前后的经颅斜径和经颅斜径差（CVA），根据CVA对治疗前后两组患儿斜头病情程度进行比较；采用Gesell儿童发育量表对两组患儿治疗前后4大能区发育商（DQ）进行评估。结果 治疗前两组斜径A、斜径B、CVA，以及动作能、应物能、语言能、应人能DQ值比较差异均无统计学意义（P > 0.05）；治疗2个月后，治疗组斜径B长于对照组（P < 0.05），CVA小于对照组（P < 0.01），各能区DQ值与对照组比较差异均无统计学意义（P > 0.05）。两组治疗后斜径A、斜径B、CVA、运动能DQ值、应物能DQ值，以及治疗组治疗后应人能DQ值均较治疗前有所改善（P < 0.01）。两组间斜头病情程度比较在治疗前后差异均无统计学意义（P > 0.05）。结论 应用睡姿矫正法治疗婴儿姿势性斜头，较英国进口的安曲婴儿正姿床垫疗效好，且更简便、经济，值得临床推广。
Objective To investigate the efficacy of 2-month course of sleeping position correction in the treatment of positional plagiocephaly in infants aged < 8 months. Methods A total of 73 infants with positional plagiocephaly between January 2015 and June 2016 were divided into treatment group (n=46) and control group (n=27) according to parents' wishes. The treatment group received sleeping position correction, while the control group received sleep curve mattress. The oblique diameters A and B in the two groups were measured and the cranial vault asymmetry (CVA) was calculated before and after treatment. The severity of positional plagiocephaly based on CVA was compared between the two groups before and after treatment. The Gesell Developmental Scale was used to determine the developmental quotients (DQs) in the motor, adaptive, language, and social domains in the two groups before and after treatment. Results Before treatment, there were no significant differences in oblique diameters A and B, CVA, and DQs in the four specific domains between the two groups (P > 0.05). After 2 months of treatment, the treatment group had a significantly greater oblique diameter B and a significantly smaller CVA than the control group (P < 0.05); there were no significant differences in DQs in the four specific domains between the two groups (P > 0.05). After treatment, both groups had significant improvements in oblique diameters A and B, CVA, and DQs in the motor and adaptive domains (P < 0.01); moreover, the treatment group showed a significant improvement in the DQs in the social domain (P < 0.01). There was no significant difference in the severity of positional plagiocephaly between the two groups before and after treatment (P > 0.05). Conclusions For infants with positional plagiocephaly, sleeping position correction has better efficacy and is more convenient and economical than the sleep curve mattress, so it holds promise for clinical application.
Positional plagiocephaly / Sleep position correction / Infant
[1] Looman WS, Flannery AB. Evidence-based care of the child with deformational plagiocephaly, Part I:assessment and diagnosis[J]. J Pediatr Health Care, 2012, 26(4):242-250.
[2] Bialocerkowski AE, Vladusic SL, Wei Ng C. Prevalence, risk factors, and natural history of positional plagiocephaly:a systematic review[J]. Dev Med Child Neurol, 2008, 50(8):577-586.
[3] Fontana SC, Daniels D, Greaves T, et al. Assessment of deformational plagiocephaly severity and neonatal developmental delay[J]. J Craniofac Surg, 2016, 27(8):1934-1936.
[4] Hutchison BL, Stewart AW, De Chalain TB, et al. A randomized controlled trial of positioning treatments in infants with positional head shape deformities[J]. Acta Paediatr, 2010, 99(10):1556-1560.
[5] Morris LM. Nonsyndromic craniosynostosis and deformational head shape disorders[J]. Facial Plast Surg Clin North Am, 2016, 24(4):517-530.
[6] 吴至凤, 李智雅, 赵聪敏.头颅畸形研究概况[J]. 中国儿童保健杂志, 2014, 22(5):503-505.
[7] Biggs WS. Diagnosis and management of positional head deformity[J]. Am Fam Physician, 2003, 67(9):1953-1956.
[8] Sillifant P, Quirk D, Duncan C. Treatment of deformational plagiocephaly with the sleep curve mattress[J]. Br J Oral Maxillofac Surg, 2011, 49(Suppl 1):S12-S13.
[9] Sillifant P, Vaiude P, Bruce S, et al. Positional plagiocephaly:experience with a passive orthotic mattress[J]. J Craniofac Surg, 2014, 25(4):1365-1368.
[10] Looman WS, Flannery AB. Evidence-based care of the child with deformational plagiocephaly, Part I:assessment and diagnosis[J]. J Pediatr Health Care, 2012, 26(4):242-250.
[11] Sergueef N, Nelson KE, Glonek T. Palpatory diagnosis of plagiocephaly[J]. Complement Ther Clin Pract, 2006, 12(2):101-110.
[12] Rogers GF. Deformational plagiocephaly, brachycephaly, and scaphocephaly. Part II:prevention and treatment[J]. J Craniofac Surg, 2011, 22(1):17-23.
[13] Cummings C. Positional plagiocephaly[J]. Paediatr Child Health, 2011, 16(8):493-496.
[14] 何丽, 奚敏, 曾宪吉. 蝶形凹式枕在新生儿暖箱中的应用[J]. 重庆医学, 2009, 38(22):2818.
[15] Speltz ML, Collett BR, Stott-Miller M, et al. Case-control study of neurodevelopment in deformational plagiocephaly[J]. Pediatrics, 2010, 125(3):e537-e542.
[16] Zhao XQ, Wang LY, Zhao CM, et al. Neurological assessment of Chinese infants with positional plagiocephaly using a Chinese version of the Infant Neurological International Battery (INFANIB)[J]. Childs Nerv Syst, 2017, 33(2):281-288.
[17] Aarnivala H, Vuollo V, Harila V, et al. The course of positional cranial deformation from 3 to 12 months of age and associated risk factors:a follow-up with 3D imaging[J]. Eur J Pediatr, 2016, 175(12):1893-1903.
[18] Balan P, Kushnerenko E, Sahlin P, et al. Auditory ERPs reveal brain dysfunction in infants with plagiocephaly[J]. J Craniofac Surg, 2002, 13(4):520-526.
[19] Cavalier A, Picot MC, Artiaga C, et al. Prevention of deformational plagiocephaly in neonates.[J]. Early Hum Dev, 2011, 87(8):537-543.
第三军医大学第二附属医院临床科研项目一般项目（2014YLC30）。
