痉挛型脑瘫患儿的社会生活能力特征及其相关性研究

关键词：脑性瘫痪  社会生活能力  儿童  痉挛  活动受限

Keywords:cerebral palsy  social life ability  children  spasticity  activity limitation

摘要：

      摘要 目的：了解痉挛型脑瘫（SCP）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154例1—12岁的痉挛型脑瘫患儿及其家长进行调查，并通过非参数秩和检验、单因素方差分析，多变量方差分析，Pearson和Spearman相关性分析，确定不同性别、年龄、瘫痪类型和严重程度的患儿社会生活能力状况。 结果：社会生活能力边缘以上（≥9分）的患儿占63%，幼儿期分别与学龄前期、学龄期比较，不同瘫痪类型、GMFCS组别比较，边缘以上的患儿数量比例的差异有显著性意义（P<0.05）。患儿社会生活能力各项分值在不同年龄组间比较，差异有显著性意义（P<0.05）。不同瘫痪类型比较，社会生活能力中的独立生活、运动、作业和参加集体活动区域，差异有显著性意义（P<0.05）。GMFCS组别间比较，社会生活能力差异有显著性意义（P<0.05）。患儿的标准分与其年龄（r=-0.223，P=0.005）和GMFCS分级水平（r=-0.479，P=0.000）呈负相关。 结论：脑瘫患儿随着年龄的增长，其社会生活能力有明显提高，但与同年龄段正常儿童相比，其差距却更加明显；活动受限程度越重的患儿，其社会生活能力表现越差，但在交往和自我管理领域方面的能力表现可能很不错。

Abstract:

      Abstract Objective: To study the situation, characteristics and correlation of social life ability for children with spastic cerebral palsy (SCP). Method: After signing the informed consent, one hundred and fifty-four children with SCP, 1 to 12 years of age, and their caregivers were assessed with the social life ability scale for infant-junior middle school student. According to ages, gender, types of paralysis, level of gross motor function classification system (GMFCS) of children with SCP, the situation, characteristics and correlation of social life ability in children with SCP was performed with nonparametric test, one-way analysis of variances, multiple analysis of variances, Pearson and Spearman analyses. Result: Based on the raw and standard scores of social life ability, 63% of children with SCP were almost normal. The children having normal social life ability in infants group were more than preschool group and school-aged group (P<0.05). The difference of amount of children who had normal social life ability was statistically significant among GMFCS groups (P<0.05), as well as among hemiplegia, diplegia, and quadriplegia groups (P<0.05). All 6 domains scores of social life ability were statistically significantly different among 3 aged groups (P<0.05), and 4 GMFCS level groups (P<0.05). The difference in self-help, locomotion, occupation, and socialization domains scores were statistically significant among 3 types of paralysis groups (P<0.05). The standard scores were negatively correlated with age (r=-0.223, P=0.005) and GMFCS level (r=-0.479, P=0.000). Conclusion: With the growing of age, the social life ability of CP children improved better. However, compared with the same aged normal children, the gap was more obvious. The social life ability for children with SCP was associated strongly with activity limitation. However, the more activity limitation， the poorer social life ability;whereas they might have good ability in communication and self-direction domains.