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儿童颅型异常是指儿童头部形状偏离正常范围，出现不对称、扁平、狭长或其他形态异常的情况，其病因主要包括姿势性颅型异常和颅缝早闭，可影响患儿外观及神经认知发育。早期诊断和早期干预对于改善颅型、促进神经认知发育至关重要。对于姿势性颅型异常，强调基于颅顶不对称指数等量化指标分级，轻度或<5月龄患儿推荐睡姿矫正，中重度或5～18月龄患儿首选矫正头盔治疗。考虑颅缝早闭，头颅CT三维重建为诊断金标准，必要时排查基因突变。颅缝早闭的治疗策略严格遵循年龄分层与个体化原则，其中综合征型颅缝早闭强调多学科协作，优先解决颅内高压、气道梗阻及视力损伤，分期实施颅骨重塑或牵引成骨术。本共识基于循证医学证据（GRADE标准）及Delphi法制定，总结归纳了近25年的研究结果和临床诊疗策略，旨在为临床医师提供标准化的诊断路径与治疗时机选择，以改善患儿预后。
Abstract：Objective Abnormal skull shape in children is defined as deviations in head shape from the normal range, manifesting as asymmetry, flattening, elongation, or other morphological anomalies. Primary etiologies include positional head deformity and craniosynostosis, both of which may impact appearance and neurocognitive development. Early diagnosis and intervention are critical for improving cranial shape and promoting neurocognitive outcomes. For positional head deformity, emphasis is placed on grading based on quantitative indices such as the cranial vault asymmetry index; repositioning therapy is recommended for mild cases or infants younger than 5 months, whereas cranial molding helmet therapy is the preferred treatment for moderate-to-severe cases or infants aged 5 to 18 months. When craniosynostosis is suspected, three-dimensional CT reconstruction serves as the diagnostic gold standard, warranting genetic screening when necessary. Treatment strategies strictly adhere to age-stratified and individualized principles. Specifically, syndromic craniosynostosis requires multidisciplinary collaboration to prioritize the resolution of intracranial hypertension, airway obstruction, and visual impairment, followed by staged cranial vault remodeling or distraction osteogenesis. Formulated by using GRADE evidence standards and the Delphi method, this consensus synthesizes research findings and clinical strategies from the past 25 years to provide clinicians with standardized diagnostic pathways and treatment timing for optimizing patient prognosis.
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基本信息:
中图分类号:R726.5
引用信息:
[1]罗如韬,应泽生,张迪,等.儿童颅型异常诊断与治疗中国专家共识（2025）[J].中华神经外科疾病研究杂志,2026,20(04):1-15.
基金信息:
北京市科技计划项目（Z241100007724008）
2026-04-24
2026-04-24