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目的分析维生素D辅助康复治疗对脑瘫伴语言功能障碍患儿的临床疗效。方法选择2011年3月—2014年6月丽水市中心医院收治的脑瘫伴语言功能障碍患儿共82例,根据入院先后顺序,采用随机数字法将其分为单纯康复治疗组39例和维生素D辅助康复治疗组(联合组)43例,常规康复治疗包括物理治疗、推拿、语言训练等,双鲸维生素D滴剂1粒/次,1次/d,3个月为一疗程,观察患者病情变化;比较2组患儿的语言发育能力、Gesell儿童发育量表和Bayley婴幼儿发展量表评分及维生素D和血钙水平的差异性。结果治疗后联合组患儿的语言发育改善程度显著提高,总有效率大于单纯组(95.3%vs.74.4%,χ~2=7.213,P=0.007),Gesell儿童发育量表发育商数DQ平均得分显著提高[(70.4±11.3)分vs.(53.3±10.5)分,t=6.127,P=0.026],正常患儿的比例显著高于单纯组(41.9%vs.20.5%,F=4.304,P=0.038);Bayley婴幼儿发展量表发育指数优秀比例显著提高(F=9.202,P=0.002)。维生素D和血钙水平比单纯组明显增高,差异均有统计学意义[(78.9±23.8)pmol/L vs.(56.3±21.0)pmol/L,t=6.025,P=0.023;(1.9±0.4)mol/L vs.(1.3±0.1)mol/L,t=5.624,P=0.028]。结论维生素D辅助康复治疗可较为有效地改善脑瘫伴语言功能障碍患儿的语言功能及发育状况,有一定的临床应用价值。
Objective To analyze the clinical effect of vitamin D assisted rehabilitation on children with cerebral palsy with speech dysfunction. Methods A total of 82 children with cerebral palsy and language dysfunction admitted to Lishui Central Hospital from March 2011 to June 2014 were enrolled in this study. According to the sequence of hospital admission, they were divided into three groups according to the random number method: 39 cases of pure rehabilitation group and vitamin D 43 cases of adjuvant rehabilitation group (combined group), conventional rehabilitation including physical therapy, massage, language training, a double whale vitamin D drops 1 / time, 1 / d, 3 months for a course of treatment, the patient’s condition The differences in speech development ability, Gesell child development scale and Bayley infant development scale score as well as vitamin D and serum calcium levels were compared between the two groups. Results After treatment, the improvement rate of language development in the combined group was significantly higher than that in the simple group (95.3% vs 74.4%, χ ~ 2 = 7.213, P = 0.007) (70.4 ± 11.3) vs 53.3 ± 10.5 (t = 6.127, P = 0.026). The proportion of normal children was significantly higher than that of simple children (41.9% vs. 20.5%, F = 4.304, P = 0.038). The excellent proportion of Bayley infant and youth development scale development index increased significantly (F = 9.202, P = 0.002). The levels of vitamin D and serum calcium were significantly higher than those in the simple group (P <0.05), and the differences were statistically significant (78.9 ± 23.8 pmol / L vs 56.3 ± 21.0 pmol / L, t = 6.025, ) mol / L vs. (1.3 ± 0.1) mol / L, t = 5.624, P = 0.028]. Conclusion Vitamin D-assisted rehabilitation treatment can effectively improve the language function and development status of children with cerebral palsy with dysfunction of speech, and has certain clinical value.