Serebral palsili hastaların demografik ve klinik özellikleri

Year 2019, Volume: 58 Issue: 3, 265 - 273, 20.09.2019

Tuba Erdem Sultanoğlu Ece Ünlü Akyüz Alev Çevikol Hasan Sultanoğlu

https://doi.org/10.19161/etd.608467

Cited By: 3

Abstract

Amaç: Çalışmamızın amacı serebral palsi (SP) polikliniğinde SP tanısı ile
takip ve tedavisi yapılan hastalarımızın demografik ve klinik özelliklerini
belirlemektir.

Gereç ve Yöntem: Düzenli takibi olan 577 hastanın bilgileri geriye dönük incelendi.
Hastaların yaşı, cinsiyeti, etiyolojik faktörleri, problemlerin fark edildiği
yaş, SP tipi, kaba motor fonksiyon klasifikasyon sistemiyle (KMFKS)
değerlendirmesi, eşlik eden ikincil problemleri, muayene bulguları,
rehabilitasyon merkezinde düzenli tedavi hizmeti alımı, ortez ve yardımcı
cihazları, medikal tedavileri, uygulanan konservatif ve cerrahi tedavi
yaklaşımları kaydedildi.

Bulgular: Hastalarımızın %41,9’u kız, %58,1’i erkek, yaş ortalaması 6,57 (±3,17)
yıl idi. Tanı alma yaşı 0-6 ayda %31,4; 6-12 ayda %36,7; 1-2 yaşta %21,9 ve iki
yaşından sonra %10,1 idi. Olguların %23,2’sinde spastik unilateral tip,
%72,4’ünde spastik bilateral tip, %1,2’sinde diskinetik tip, %0,2’sinde
hipotonik tip ve %2,9’unda mikst tip tutulum mevcuttu. Etiyolojik faktörler
açısından %5 prenatal, %10,6 perinatal, %6,8 postnatal faktörler etkendi.
Hastalarımızın %64’ünde birden çok risk faktörü mevcutken, %13,7’sinde risk
faktörü saptanmamıştır. Rehabilitasyon merkezine devam süresi 3,05(±2,8) yıldı.
Hastaların %51'inde eşlik eden problem mevcutken %49’unda eşlik eden problem yoktu.
Hastalarımızın %9,6’sında antispastik tedavi, %22,6‘sında antikonvülzan tedavi,
%3,1’inde antispastik ve antikonvülzan tedavi, %8,4’ünde bunların dışında
medikal tedavi mevcutken, %56,3’ünde herhangi bir medikal tedavisi yoktu.
Hastaların ilk başvuruda %33,1’i ortez, %23,3'ü yardımcı cihaz kullanmaktaydı.
KMFKS’ye göre hastaların %18,5’i evre 1, %25,5’i evre 2, %18,4’ü evre 3,
%22,7’si evre 4 ve %14,9’u evre 5 idi. En sık ekin yürüyüşü saptandı.
Hastalarımızın %42,3’üne botulinum toksin enjeksiyonu, %0,7’sine selektif
dorsal rizotomi, %21’ine ortopedik cerrahi uygulanmıştı.

Sonuç: Serebral palsinin epidemiyolojik karakterinin bilinmesi, hastaların
düzenli takibi ve tedavisi çocuğun bağımlılığını en aza indirip topluma
uyumunun artmasını sağlayabilir.

Keywords

Serebral palsi, demografik ve klinik özellikler, fonksiyonel seviye, risk faktörleri.

Demographic and clinical characteristics of cerebral palsy patients

Abstract

Aim: The objective of this study is to identify the
demographic and clinical characteristics of our patients who were followed up
and treated with cerebral palsy diagnosis.

Materials and
Methods: The information
of 577 patients was analyzed.

Results: 41.9% of patients were female,58.1% were male, the
mean age was 6.57years. Age of diagnosis was 31.4% in 0-6 months; 36.7% at 6-12
months; 21.9% at 1-2 years and 10.1% after two years of age. There was spastic
unilateral type in 23.2%, spastic bilateral type in 72.4%, dyskinetic type in
1.2%, hypotonic type in 0.2% and mixed type in 2.9% of the cases. In terms of
etiologic factors,5% prenatal,10.6% perinatal,6.8% postnatal factors were
affected.64% of our patients had more than one risk factor, 13.7% had no risk
factor.

The
duration of resumption to the rehabilitation center is 3.05 years. In 51% of
the patients there was a concomitant problem, in 49% there was no accompanying
problem. Antispastic therapy was used in 9,6% of patients, anticonvulsant
therapy in 22,6%, both treatment in 3,1%, others medical treatment in 8,4%. In
56,3% of the patients was no medical treatment.33,1% of patients were using
orthosis,23,3% were using assistive devices. According to CMFCS,18.5% of the
patients were in stage 1,25.5% in stage 2,18.4% in stage 3, 22.7% in stage 4
and 14.9% in stage 5. Pes equinus was detected most frequently. Botulinum toxin
injection was applied in 42,3%, selective dorsal rhizotomy in 0,7% and
orthopedic surgery in 21% of our patients.

Conclusion: Knowing the epidemiologic character of cerebral
palsy, regular follow-up, treatment of the patients can provide the least
dependence on the child, increase the adaptation to the gathering.

Keywords

Cerebral palsy, demographic and clinical characteristics, functional level, risk factors.

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