31例婴儿体位性颅形异常的处理

Abstract

目的：探讨姿势矫正训练和矫形头盔治疗两种处理方法对婴儿中-重度体位性颅形异常的效果。方法对31例诊断为中-重度斜头异常和/或短头异常的婴儿进行研究，按照不同的处理方法分为矫形头盔治疗组（n=11）和姿势矫正训练组（n=20）。对两组患儿治疗前后头颅不对称指数（CVAI）和头颅比率（CR）及头围的增长情况进行比较。结果矫形头盔治疗组治疗后CVAI和CR均显著低于姿势矫正训练组。矫形头盔治疗组其两个测量参数CVAI和CR治疗前后的差值优于姿势矫正训练组（CVAI差值：6.0±1.9 vs 0.7±0.8, P=0.001；CR差值：0.047±0.009 vs 0.008±0.005，P<0.001）。两组患儿头围生长的比较差异无统计学意义。结论矫形头盔治疗对婴儿中-重度体位性颅形异常的治疗效果优于姿势矫正训练。矫形头盔治疗不会对患儿头颅生长造成限制。

ObjectiveTo investigate the clinical effect of postural correction training and helmet therapy in the treatment of moderate-severe positional head deformity deifned as asymmetric head shape in infants.MethodsA total of 31 infants who were diagnosed with moderate-severe plagiocephaly and/or brachiocephaly were enrolled. According to the different treatment methods, the infants were divided into helmet therapy group with 11 infants and postural correction training group with 20 infants. The cranial vault asymmetry index (CVAI), cephalic ratio (CR), and head circumference growth were compared between the two groups before and after treatment.ResultsCompared with the postural correction training group, the helmet therapy group had signiifcantly lower CVAI and CR after treatment. The helmet therapy group had signiifcantly better improvements in CVAI and CR after treatment compared with the postural correction training group (CVAI difference: 6.0±1.9 vs 0.7±0.8,P=0.001; CR difference: 0.047±0.009 vs 0.008±0.005, P<0.001). There was no significant difference in head circumference growth between the two groups (P=0.55). ConclusionsHelmet therapy has a significantly better effect in the treatment of moderate-severe positional head deformity than postural correction training in infants. Helmet therapy does not limit head circumference growth.