101例婴儿斜头异常的临床分析

A clinical analysis of 101 infants with plagiocephaly

摘要:

目的 探讨引起婴儿斜头异常的可能原因，以及姿势矫正训练对斜头异常的改善效果。方法 选择诊断为斜头异常的患儿101例进行研究，按照诊断斜头异常时的年龄分为3组：1~4月龄组 （n=31）、5~8月龄组 （n=40）和9~12月龄组 （n=30）。对3组患儿斜头异常的可能原因进行调查分析，并对3组患儿给予姿势矫正训练前后头颅不对称指数 （CVAI）进行比较。结果 101例患儿中，89例 （88.1%）患儿为仰卧位固定睡姿，3组间此睡姿率比较差异无统计学意义。1~4月龄组患儿早产出生率、不良围产因素发生率及先天性肌性斜颈的发生率高于5~8月龄组和9~12月龄组，差异有统计学意义。3组患儿姿势矫正训练3个月后CVAI值均较训练前显著下降 （P < 0.001）。1~4月龄组给予姿势矫正训练前后CVAI差值显著大于5~8月龄组和9~12月龄组 （P < 0.001）。结论 仰卧位固定睡姿可能与婴儿斜头异常的发生有关；不良围产因素、早产出生及先天性肌性斜颈作为婴儿斜头异常的可能原因更常见于婴儿早期；姿势矫正训练对婴儿斜头异常改善有意义，特别是对婴儿早期的斜头异常的改善效果更明显。

Abstract:

Objective To investigate the possible causes of plagiocephaly in infants and the therapeutic effect of postural correction training on plagiocephaly. Methods A total of 101 infants who were diagnosed with plagiocephaly were enrolled. According to the age at diagnosis, these infants were divided into 1-4 month group (31 infants), 5-8 month group (40 infants), and 9-12 month group (30 infants). The possible causes of plagiocephaly were analyzed in three groups. The cranial vault asymmetry index (CVAI) before and after postural correction training was compared in three groups. Results Of the 101 infants, 89 (88.1%) had a sleeping posture in the supine position, and there was no significant difference in the percentage of infants with such posture between the three groups. Compared with the 5-8 month group and the 9-12 month group, the 1-4 month group had significantly higher rate of preterm birth, incidence rate of adverse perinatal factors, and incidence rate of congenital muscular torticollis. The three groups showed a significant decrease in CVAI 3 months after postural correction training (P < 0.001). Compared with the 5-8 month group and the 9-12 month group, the 1-4 month group had a significantly greater change in CVAI after postural correction training (P < 0.001). Conclusions The sleeping posture in the supine position may be associated with the development of plagiocephaly. Adverse perinatal factors, preterm birth, and congenital muscular torticollis as possible causes of plagiocephaly are commonly seen in early infancy. Postural correction training has a significant effect in improving plagiocephaly, especially in early infancy.