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目的了解脑瘫患儿社会生活能力的现状、特征及其与年龄、严重程度的相关性。方法采用粗大运动功能分级系统(GMFCS)评价患儿的严重程度,应用有中国常模的婴儿—初中生社会生活能力量表对79例1~14岁不伴智力低下的脑瘫患儿和79例正常对照组儿童的家长进行调查,分析不同年龄、瘫痪类型和严重程度的患儿的社会生活能力状况,并与正常对照组进行比较。结果在交往、自我管理方面,患儿与正常儿童比较,差异无统计学意义(P>0.05)。但在独立生活、运动、作业、参加集体活动能力及总的社会生活能力得分方面,与正常儿童相比,各年龄段的差异均有统计学意义(P<0.05);不同瘫痪类型与正常儿童之间比较,差异有统计学意义(P<0.05),进一步两两比较结果显示,偏瘫患儿高于双瘫,双瘫高于四肢瘫;各项分值GMFCS组别间比较,组间差异均有统计学意义(P<0.05),进一步两两比较结果显示,正常组、GMFCSⅠ级、Ⅱ级、Ⅲ级、Ⅳ/Ⅴ级之间比较差异均有统计学意义(P<0.05);患儿的GMFCS分级水平与其标准分呈负相关(γs=-0.517,P=0.000)。结论脑瘫患儿的社会生活能力为活动受限所影响,活动受限程度越高的患儿,其社会生活能力表现越差,但在交往和自我管理方面的能力影响相对较小。
Objective To understand the status quo and characteristics of social living ability of children with cerebral palsy and their correlation with age and severity. Methods To evaluate the severity of children with GMFCS, 79 cases of children with cerebral palsy without mental retardation aged 1 to 14 and 79 cases with cerebral palsy were enrolled in this study. Parents of children in the normal control group were surveyed to analyze the social viability of children of different ages, paralysis types and severity, and compared with the normal control group. Results There was no significant difference in the communication and self-management between children and normal children (P> 0.05). However, compared with normal children, the differences among all age groups were statistically significant (P <0.05) in terms of independent living, exercise, homework, ability to participate in group activities and overall social life ability scores; different types of paralysis with normal children (P <0.05). Further comparisons showed that the children with hemiplegia were higher than those with double paralysis and double paralysis were higher than those with quadriplegia. There was no significant difference between the scores of the GMFCS groups (P <0.05). Further comparisons showed that there were significant differences between the normal group, GMFCS Ⅰ, Ⅱ, Ⅲ, Ⅳ / Ⅴ (P <0.05) Children’s GMFCS classification level was negatively correlated with its standard score (γs = -0.517, P = 0.000). Conclusion Children with cerebral palsy have limited social activities and limited mobility. Children with more limited mobility have poorer social life skills, but have less influence on communication and self-management.