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【目的】探讨综合康复治疗后脑瘫患儿生存质量变化及影响生存质量改变的因素。【方法】本研究以2007—2009年在本院就诊的70例2~6岁的脑瘫患儿为研究对象,采用儿童生存质量测定量表(the pediatric quality of lifeinventory measurement models,PedsQL)4.0作为患儿生存质量的测定工具,综合康复治疗半年后评价患儿生存质量的改变及影响生存质量改变的因素。【结果】70例脑瘫患儿中男48例,女22例,平均月龄为(35.3±11.3)月;7例上幼儿园,入学率仅为10%;其治疗前后得分分别为:生理功能25.40±21.84、31.38±24.98;情感功能64.00±20.16、67.28±18.62;社交功能29.14±21.97、34.50±21.32;PedsQL总分为37.16±16.45、42.22±17.06。经配对设计的t检验,综合康复治疗前后患儿在生理功能、社交功能和PedsQL总分方面的差异具有统计学意义(P<0.01);影响生存质量改变的多因素方差分析表明,家庭月收入在3 000元以上及教育程度为小学的父母对患儿生存质量改变起正向作用。而粗大运动功能分级系统(Gross Motor Classification System,GMFCS)对生存质量的改变不具有统计学意义(P=0.797)。【结论】综合康复治疗能提高脑瘫患儿的生存质量,影响因素分析提示要投入更多的人力和财力来提高脑瘫儿的生存质量。
【Objective】 To investigate the changes of quality of life and the factors that affect the quality of life in children with cerebral palsy after comprehensive rehabilitation. 【Methods】 In this study, 70 children aged 2 ~ 6 years old with cerebral palsy treated in our hospital from 2007 to 2009 were enrolled in the study. The pediatric quality of life investi- gation models (PedsQL) 4.0 Children’s quality of life measurement tool, integrated rehabilitation evaluation of six months after the change in quality of life of children and affect the quality of life changes in the factors. 【Results】 Among the 70 children with cerebral palsy, 48 were male and 22 were female, with an average age of (35.3 ± 11.3) months. Seven of them were enrolled in kindergarten, the enrollment rate was only 10%. The scores before and after treatment were: physiological function ± 21.84,31.38 ± 24.98; emotional function 64.00 ± 20.16,67.28 ± 18.62; social function 29.14 ± 21.97,34.50 ± 21.32; PedsQL total score was 37.16 ± 16.45,42.22 ± 17.06. The paired t-test showed that there was significant difference in physical function, social function and total score of PedsQL before and after rehabilitation (P <0.01). Multivariate analysis of variance that affected the quality of life showed that monthly family income In 3 000 yuan and education level of primary school parents on the quality of life of children with a positive change. However, gross motor classification system (GMFCS) did not change the quality of life significantly (P = 0.797). 【Conclusion】 Comprehensive rehabilitation can improve the quality of life in children with cerebral palsy. The analysis of influential factors suggests that more human and financial resources should be devoted to improve the quality of life of children with cerebral palsy.