脑性瘫痪儿童听力障碍特点及对发育的影响

关键词：脑性瘫痪  听力障碍  儿童  发育

Keywords:cerebral palsy  hearing impairment  children  development

摘要：

      摘要 目的：探讨脑瘫（CP）儿童伴有听力障碍的特点，听力障碍对其发育的影响。 方法：对2018年12月—2019年11月，佳木斯大学附属第三医院确诊的94例CP儿童进行脑干听觉诱发电位（BAEP）检测。根据BAEP结果在听力障碍组抽取10例为观察组，无听力障碍组抽取10例为对照组。两组均入院接受康复训练，于治疗前、治疗8周后采用格塞尔发育诊断量表（GDDS）评估。 结果：CP儿童听力障碍以双侧性、轻度为主。不随意运动型CP听力障碍发生率明显高于痉挛型。粗大运动功能分级系统（GMFCS）Ⅳ—Ⅴ级听力障碍发生率明显高于Ⅰ—Ⅲ级。两组GDDS各项发育商（DQ）较治疗前均显著提高（P<0.05），两组GDDS大运动、精细运动治疗前后DQ的差值均无显著性差异（P>0.05），对照组适应性、语言、个人—社交治疗前后DQ差值均显著高于观察组（P<0.05）。 结论：CP儿童听力障碍以双侧性、轻度为主。CP儿童听力障碍的发生率与CP类型、GMFCS分级相关。听力障碍可能对CP儿童适应性、语言、个人—社交的发育产生消极影响。

Abstract:

      Abstract Objective： To explore the characteristics of hearing impairment in children with cerebral palsy (CP)， and the effect of hearing impairment on their development. Method： Brainstem auditory evoked potential(BAEP) tests were performed on 94 CP children diagnosed in the Third Affiliated Hospital of Jiamusi University from December 2018 to November 11， 2018. According to results of BAEP， 10 cases from the hearing impairment group were selected as the observation group， and 10 cases from the hearing-impaired group were selected as the control group. Both groups were admitted to the hospital for rehabilitation training， and were assessed using the Gesell Developmental Diagnostic Scale(GDDS) before and after 8 weeks treatment. Result： Hearing impairment in children with CP was bilateral and mild. The incidence of hearing loss of involuntary CP was significantly higher than that of spastic type. The gross motor function grading system (GMFCS) had a significantly higher incidence of hearing impairment of grades Ⅳ—Ⅴ than grades Ⅰ—Ⅲ. The development quotients (DQ) of GDDS in the two groups were significantly higher than before treatment (P<0.05). There was no significant difference in DQ between the two groups before and after GDDS exercise and fine exercise treatment (P>0.05). The differences in DQ before and after adaption， language， and personal-social treatment were significantly higher than those in the observation group (P<0.05). Conclusion： Hearing impairment in CP children is bilateral and mild. The incidence of CP with hearing impairment is related to the CP type and GMFCS classification. Hearing impairment may negatively affect the adaptation， language， and personal-social development of CP children.