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目的了解婴幼儿时期脑性瘫痪(简称脑瘫)患儿的智力水平及智力结构,分析患儿粗大运动功能障碍程度与智能发育状况的相关性。方法选取2008年1-12月在广州中医药大学附属南海妇产儿童医院儿童康复科住院的108例脑瘫患儿作为研究对象,采用北京Gesell发育量表测量患儿动作能、言语能、应物能及应人能,采用粗大运动功能分级系统(GMFCS)评定患儿粗大运动功能级别,探讨患儿运动、语言、个人社交、社会适应能力的发育状况及其与GMFCS分级的相关性。结果 108例脑瘫患儿中93.5%(101/108例)伴智能发育障碍;患儿各个能区的平均得分明显低于正常,动作能29.08±18.05,言语能37.96±23.45,应物能34.65±21.43,应人能33.43±22.23,其中动作能得分最低,言语能得分最高,差异有统计学意义(Pa<0.05);GMFCS分级与动作能、言语能、应物能及应人能均呈显著负相关(r=-0.739、-0.632、-0.659、-0.679,Pa<0.01)。结论多数脑瘫患儿存在智能发育障碍,表现在社会适应、个人社交、语言及运动等发育落后及智力结构异常;粗大运动功能障碍程度与智能发育呈负相关,GMF-CS分级越高,智能发育越落后。脑瘫患儿智能发育的康复需引起重视,尤其对于运动障碍严重者。
Objective To understand the mental status and mental structure of children with cerebral palsy (abbreviated as cerebral palsy) in infants and toddlers, and to analyze the correlation between the severity of motor dysfunction and the mental development in children. Methods From January to December 2008, 108 children with cerebral palsy who were hospitalized in Children’s Rehabilitation Department of Nanhai Maternity and Childrens Hospital, Guangzhou University of Chinese Medicine were selected as subjects. The Gesell development scale was used to measure the motor function, verbal energy, To assess the level of motor function in children with gross motor function grading system (GMFCS), and discuss the development of children’s motor, language, personal social and social adaptability and their correlation with GMFCS grading. Results In 108 children with cerebral palsy, 93.5% (101/108 cases) had mental retardation. The average scores of all energy regions in children were significantly lower than those in normal subjects. The mean scores of movements were 29.08 ± 18.05, speech was 37.96 ± 23.45, 21.43 and 33.43 ± 22.23, respectively. Among them, the score of motor activity was the lowest, the score of speech was the highest, the difference was statistically significant (Pa <0.05), and GMFCS classification and motor activity, verbal energy, Negative correlation (r = -0.739, -0.632, -0.659, -0.679, Pa <0.01). Conclusion Most children with cerebral palsy have mental retardation, which is characterized by social development, social development, language development and mental retardation and abnormal mental structure. The degree of gross motor dysfunction is negatively correlated with the development of intelligence. The higher the GMF-CS classification, the more intelligent development The more backward. The rehabilitation of cerebral palsy children with intellectual development needs attention, especially for those with severe motor disorders.