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目的 分析脑瘫患儿口运动与进食障碍的发生率与症状学 ,并对营养状况进行初步评价。方法 2 0 0 2年 3月～ 2 0 0 3年 3月住院康复的脑瘫患儿 5 9例 ,男 39例 ,女 2 0例 ,平均年龄 31个月 (2 0～ 72个月 )。父母问卷调查了解高危因素、喂养史 ,神经病学检查评价脑瘫类型 ,Gesell发育评分评价运动发育年龄 ,测体重、身高评价营养状况 ,对所有患儿进行口运动与进食技能评分与现场观察 ,按年龄、性别匹配对照组进行对比分析。结果 5 9例患儿中口运动障碍 5 1例 ,所有徐动型和痉挛型四肢瘫、16例痉挛型双瘫患儿存在口运动异常 ,脑瘫组平均口运动评分为 (2 5± 15 )分 ,低于对照组儿童 (t=11 5 87,P <0 0 0 1)。口运动异常涉及下颌、唇、舌的各个运动测试亚项。 5 5例患儿存在进食方面问题 ,绝大多数患儿进食过程中需要家长帮助 ,半数患儿仅能进食流质和 (或 )半流质 ,不能进食固体食物。进食技能障碍主要表现在口相和口前相 ,脑瘫组进食技能分平均 (35± 11)分 ,亦明显低于对照儿童 (t=4 5 5 2 ,P <0 0 0 1) ,徐动型总分较低 ,其次是痉挛型四肢瘫。脑瘫组 13例患儿体重低于第 2 5百分位数 ,19例患儿身高低于第 2 5百分位数 ,提示体格发育存在受阻现象。结论 绝大多数脑瘫患儿存在口运动和进食障碍 ,
Objective To analyze the incidence and symptoms of mouth movement and eating disorders in children with cerebral palsy, and to evaluate the nutritional status. Methods From March 2002 to March 2003, 59 children with cerebral palsy who were in hospital were enrolled. There were 39 males and 20 females, with a mean age of 31 months (range, 20 to 72 months). Parents questionnaire to understand the risk factors, feeding history, neuropathological evaluation of cerebral palsy type, Gesell development score evaluation of sports developmental age, body weight, height evaluation of nutritional status, all children with oral motor and eating skills score and field observation, by age , Gender matched control group for comparative analysis. Results Fifty-one cases of midbrain dyskinesia were found in 51 cases, all of them were paralysis of all types, and 16 cases of spastic diplegia had abnormalities of mouth movement. The mean oral motor score of cerebral palsy group was (25 ± 15) Points, lower than the control group of children (t = 11 5 87, P <0 0 0 1). Mouth dyskinesia involves the mandibular, labial, and sublingual test. 5 5 cases of eating problems in children, the vast majority of children need parental help during feeding, half of children can only eat liquid and / or semi-liquid, can not eat solid food. Eating skills disorders mainly in the mouth and mouth phase, cerebral palsy group eating skills average (35 ± 11) points, also significantly lower than the control children (t = 4552, P <0.001), Xu move Type total score lower, followed by spastic quadriplegia. The body weight of 13 children with cerebral palsy group was lower than the 25th percentile, and the height of 19 children was lower than the 25th percentile, suggesting the phenomenon of physical development was blocked. Conclusion Most children with cerebral palsy have mouth movement and eating disorders,