超声引导脑室内神经干细胞移植治疗小儿脑瘫

摘要

目的 探讨超声引导下经皮侧脑室穿刺脑室内神经干细胞(NSCs)移植治疗脑瘫的方法及近期疗效.方法 45例脑瘫患儿接受超声引导下经皮穿刺脑室内NSCs移植术.NSCs来自自然流产的孕12周人胚胎前脑组织.采用常规彩色多普勒超声诊断仪,普通扇扩探头,频率2.0～4.0 MHz,带有穿刺架和引导软件.结果 45例患儿共接受56次超声引导下侧脑室穿刺,1次穿刺成功率为100%,脑室内注入NSCs 0.3～1.2 ml,平均(0.8±0.5)ml,细胞计数3.8×106～7.2×107个,平均(12.0±6.8)×106个;3例患儿有轻度脑室血管损伤,14例术后出现发热,经对症处理体温恢复正常.术后21例(21/45,46.67%)近期临床表现有不同程度好转,无术后病情加重病例.结论超声引导下脑室内NSCs移植术安全、准确、穿刺成功率高,有助于改善脑瘫患儿的临床症状.%Objective To assess the course of percutaneous puncture of the lateral ventricle guided with ultrasonography,and to observe the short-term effectiveness of transplantation of human fetal neural stem cells (NSCs) into the cerebral ventricle in treatment of cerebral palsy (CP) of children. Methods Forty-five children of CP with different causes underwent transplantation of NSCs through the lateral ventricle guided with ultrasonography. NSCs were obtained from the forebrain of 12-week old fetuses because of natural abortion. Color Doppler ultrasound with sector detector, puncture frame and guidance software were used. Results Fifty-six taps were carried out and 0.3-1.2 ml (mean [0. 8±0. 5]ml) suspensions containing 3. 8 × 106-7.2 × 107 (mean [12. 0±6.8] × 106 ) NSCs were transplanted into the cerebral ventricles. The success rate of once puncture was 100％, during which mild injury of lateral ventricle blood vessel of the children occurred in 3 cases. Though 14 cases had fever, short-term clinical manifestations were improved in varying degrees in 21 cases (21/45,46.67 ％) after the transplantation. No patient's condition worsened. Conclusion Transplantation of NSCs into the lateral ventricle guided with ultrasonography is safe and accurate, and helps to improve the clinical symptoms for children with CP.