Katona治疗中重度围产期脑损伤的远期疗效
Long-Term therapeutic effects of Katona therapy in moderate-to-severe perinatal brain damage
摘要：
目的：确定Katona治疗和早期康复对中重度围产期脑损伤（PBD）婴儿的长期疗效。研究方法：招募了32名参与者（7至16岁），并分为3组：一组健康组（n = 11），一组患有PBD，从矫正年龄2个月开始接受Katona方法治疗，并进行长期随访（n = 12），一组患有PBD，但由于PBD诊断较晚，在出生后第一年未接受治疗（n = 9）。进行神经儿科评估、运动诱发电位（MEP）和磁共振成像（MRI）。PBD组按病变严重程度和地形匹配。结果如下：与未接受早期治疗的患者相比，接受Katona治疗的患者的运动表现更好（粗大运动功能分类系统水平; Katona组75%的患者被分类为I级和II级，未接受早期治疗的患者78%被分类为III级和IV级）。此外，对MRI、MEP和神经儿科评价数据进行了独立的k均值聚类分析。Katona和未治疗的早期组被分类在相同的MRI聚类中，这是PBD患者人群的预期结果。然而，在MEP和神经儿科评估聚类中，67%的Katona组被分配到健康组，显示Katona治疗对接受治疗的患者的影响。这些结果突出了Katona治疗在中重度PBD婴儿早期康复中的益处。结论：Katona治疗和早期康复对中重度PBD婴儿具有重要的治疗作用，可降低其生命后期运动障碍的严重程度。
英文摘要：
Aim: To determine the long-term efficacy of Katona therapy and early rehabilitation of infants with moderate-to-severe perinatal brain damage (PBD). Methods: Thirty-two participants were recruited (7-to-16 years) and divided into 3 groups: one Healthy group (n = 11), one group with PBD treated with Katona methodology from 2 months of corrected age, and with long-term follow-up (n = 12), and one group with PBD but without treatment in the first year of life due to late diagnosis of PBD (n = 9). Neuropediatric evaluations, motor evoked potentials (MEPs) and magnetic resonance images (MRI) were made. The PBD groups were matched by severity and topography of lesion. Results: The patients treated with Katona had better motor performance when compared to patients without early treatment (Gross Motor Function Classification System levels; 75% of Katona group were classified in levels I and II and 78% of patients without early treatment were classified in levels III and IV). Furthermore, independent k-means cluster analyses of MRI, MEPs, and neuropediatric evaluations data were performed. Katona and non-treated early groups were classified in the same MRI cluster which is the expected for patient's population with PBD. However, in MEPs and neuropediatric evaluations clustering, the 67% of Katona group were assigning into Healthy group showing the impact of Katona therapy over the patients treated with it. These results highlight the Katona therapy benefits in early rehabilitation of infants with moderate-to-severe PBD. Conclusions: Katona therapy and early rehabilitation have an important therapeutic effect in infants with moderate-to-severe PBD by decreasing the severity of motor disability in later stages of life.
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