艾戎,邓冰,孙明明,周琳业,越敏
AI Rong 1; DENG Bing 2; SUN Ming-ming 1; ZHOU Lin-ye 2; YUE Min 1 (1.Department of Pediatric;

• 1:贵阳医学院附院儿科
• 2:贵阳医学院预防医学系
• 3:贵阳医学院附院儿科
• 4:贵阳医学院预防医学系

摘要(Abstract)：

目的 :对脑性瘫痪 (cerebralplasy ,以下简称脑瘫 )患儿进行院内康复与社区家庭康复疗效的对比研究 ,以探求切实、可行、有效的治疗 ,并通过对脑瘫高危因素的研究 ,提高脑瘫的早期诊断、早期治疗。方法 :以问卷方式详细记录 5 0例脑瘫患儿家族史、母亲孕期情况、围产期情况、新生儿期疾病、智力及运动发育情况、神经系统情况及其它伴随症状 ,并进行相关检查。将所有病人随机分成两组 :院内康复治疗组及社区家庭康复治疗组 ,治疗前后由专人做儿童心理行为测定量表 (以下简称儿心量表 )测定。结果 :(1)脑瘫的高危因素以出生前及围产期的因素为主 ;(2 )院内康复组与社区家庭康复组在治疗前后 ,儿心量表各能区及智龄和发育商的差异有显著性 (P <0 0 1) ;(3)院内康复治疗和家庭康复治疗后 ,脑瘫患儿在粗大动作、语言、社交行为的差异无显著性。精细动作、适应能力的差异有显著性 (P <0 0 1) ,院内康复治疗优于家庭康复治疗。结论 :(1)院内康复及社区家庭康复均是有效的治疗方式 ;(2 )加强脑瘫的三级预防措施 ,可达到减少脑瘫的发生 ,减轻脑瘫患儿的残疾程度进而达到提高脑瘫患儿生存质量的目的。
Objective: Through the curative results comparison between hospital rehabilitation and community family rehabilitation,we try to investigate the practical and effective treatment to cerebral palsy.By the study of the high-risk factors about the happening of cerebral palsy,we can improve the early diagnosis and early intervention of cerebral palsy.Methods:50 cases of cerebral palsy children were investigated.Family history,mothers’pregnant period(diseases and drug-intake),perinatal conditions,newborn diseases,development of intelligence and exercise,examination results of nerves and other symptoms(e.g.fed difficulty,sleep disorder,epilepsy,etc) were recorded by questionnaire method.Relative examinations were taken as the following:brain CT,electroencephalogram,etc.The patients were then divided into two groups randomly for different treatments,hospital rehabilitation and community family rehabilitation.The period of treatment was 3 months.The intelligence scale for children was tested before and after the treatment.Results:1) High-risk factors of cerebral palsy occurred mainly before birth and during perinatal period;2)there were obvious differences in mental age,development quotient and intelligent factors of the intelligence scale between the two groups after the treatment(P<0.01); 3)After the treatments,there was no obvious difference in gross motor area,language area,social area and development quotient,while obvious differences occurred in fine motor area,adaptive area and mental age.(P<0.01);Conclusions:Both hospital rehabilitation and community family rehabilitation are effective treatments.The investigation of high-risk factors shows that we can reduce the happening of cerebral palsy,lighten the degree of deformity and improve the quality of life by strengthening the performance of“Three-degree Preventions”for cerebral palsy.

关键词(KeyWords)： 脑性瘫痪;康复护理;儿童;院内康复;社区家庭康复;高危因素
cerebral palsy; rehabilitation nursing; child; hospital rehabilitation; community family rehabilitation; high-risk factor

Abstract:

Keywords:

基金项目(Foundation):

作者(Authors): 艾戎,邓冰,孙明明,周琳业,越敏
AI Rong 1; DENG Bing 2; SUN Ming-ming 1; ZHOU Lin-ye 2; YUE Min 1 (1.Department of Pediatric;

DOI: 10.19367/j.cnki.1000-2707.2004.05.015

参考文献(References)：

• [1]林庆.小儿脑性瘫痪[M].北京:北京医科大学出版社,2000.60-61.
• [2]StanleyFJ ,BlairE .Cerebralpalsy[M].In:PlessIB .Theepi demiologyofchildhooddisorders[M].NewYork:OxfordUni versitypress,1994.473.
• [3]李树春.小儿脑性瘫痪[M].河南:科学技术出版社,2002.5-10.
• [4]林庆.小儿脑性瘫痪的定义、诊断条件及分型[J].中华儿科杂志,1989,27(3):162-163.
• [5]胡莹媛.小儿脑性瘫痪智能评定探讨[J].中国康复,1996,11:70-72.
• [6]AnandalakshmyS .ApproachestoProgrammingforEarlyChildhoodDevelopment[M].Bangkok:UNICEF ,1986.1-10.
• [7]周雪娟,陈彤,江克文,等.Gesell发育量表对婴幼儿脑性瘫痪康复疗效的评估[J].中国康复医学杂志,1999,14(5):205-207.
• [8]BuljinaA ,ZubcevicS ,UzicaninS ,etal.Theroleofriskfac torsindevelopmentaldiagnosis[J].MedArh,1999,53(2):5-8.
• [9]黄真,苏伟,席宇诚,等.高危新生儿的早期干预及脑性瘫痪的早期治疗[J].中国康复医学杂志,2002,17(2):97-99.
• [10]石坚,封志纯,刘利辉,等.高危脑瘫婴幼儿早期康复的疗效与价值[J].中华物理医学与康复杂志,2002,24(8):462-464.
• [11]李燕春,胡莹媛,刘建军,等.婴儿脑性瘫痪早期治疗的临床观察[J].中国康复医学杂志,2002,17(5):282-283.
• [12]YamashitaY ,MatsuishiT .Theeffectivenessofearlyinter ventionforvery liw weightinfants[J].NoToHattatsu,2002,34(2):153-157.
• [13]PharoahPO ,CookeT ,RosenbloomI ,etal.Trendsinbirthprevalenceofcerebralpalsy[J].ArchDisChild,1987,62:379-384.

文章评论(Comment)：