文章摘要
李倩,王松青,侯梅,苑爱云,李淑秋,乔卫卫.脑瘫患儿语言发育迟缓及其与粗大运动功能分级的关系[J].中国康复,2014,29(2):89-92
脑瘫患儿语言发育迟缓及其与粗大运动功能分级的关系
Language retardation and its relationship with the GMFCS levels in children with cerebral palsy
  
DOI:
中文关键词: 脑性瘫痪  语言发育  语言理解和/表达迟缓  言语障碍  粗大运动功能分级系统
英文关键词: cerebral palsy  language development  language reception and/or expression retardation  speech disorder  Gross Motor Function Classification System (GMFCS)
基金项目:
作者单位
李倩 青岛大学医学院康复医学与理疗学山东 青岛 266000 
王松青 青岛市海慈医院儿科山东 青岛 266000 
侯梅 青岛市妇女儿童医院神经康复科山东 青岛 266034 
苑爱云 青岛市妇女儿童医院神经康复科山东 青岛 266034 
李淑秋 青岛市妇女儿童医院神经康复科山东 青岛 266034 
乔卫卫 青岛市妇女儿童医院神经康复科山东 青岛 266034 
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中文摘要:
  目的:探讨不同类型脑瘫患儿语言发育迟缓发生率、迟缓程度及其与粗大运动功能分级水平的关系。方法:采用粗大运动功能分级(GMFCS)系统、S-S语言发育迟缓检查法,对113例脑瘫患儿进行评估,分析语言发育迟缓率与脑瘫类型和GMFCS分级水平的相关关系。结果:113例脑瘫患儿中,GMFCSⅠ~Ⅱ级42例,Ⅲ级27例,Ⅳ~Ⅴ级44例。大多数偏瘫患儿属于轻度运动障碍,语言理解和表达迟缓率仅为18.75%和37.5%;痉挛型双瘫中半数为轻度运动障碍、半数为中重度运动障碍,语言理解和表达发育迟缓率分别为66.67%和83.33%;痉挛型四肢瘫、失调型、不随意运动型和混合型脑瘫患儿以中重度运动障碍为主,语言发育迟缓率依次为88.89%、75.00%、91.67%、71.43%,虽然后两者语言发育商得分理解明显高于表达(均P<0.05),但语言理解与表达迟缓率相当。GMFCS和语言发育水平呈正相关 (理解r=0.402,表达r=0.389,P<0.01)。结论:语言发育迟缓是脑瘫患儿常见的伴发障碍,其发生率和严重程度与脑瘫类型、运动障碍程度明显相关。痉挛型四肢瘫、不随意运动型、混合型脑瘫以及GMFCS水平Ⅲ~V级的脑瘫患儿语言迟缓率高且程度重,应及早介入言语康复。
英文摘要:
  Objective:To analyze the correlation of language development level with types of cerebral palsy (CP) and gross motor function in children with CP.Methods:The children with CP treated in Qingdao Women and Children's Hospital from January 2012 to January 2013 were assessed with Gross Motor Function Classification System (GMFCS),and Sign-Significate Language Development Test.The retardation rate and severity of language reception and expression as well as their relationships with the CP types and GMFCS levels were explored.Results:Among 113 cases,42 were in GMFCS levels Ⅰ and Ⅱ,27 in Ⅲ,and 44 in Ⅳ and Ⅴ.Most children with hemiplegia belonged to the mild movement disorders:18.75% delay in language reception and 37.5% delay in language expression.Of the children with spastic diplegia,half were for mild dyskinesia and half for moderate and severe dyskinesia:28/42 (66.67%) delay in language reception and 35(83.33%) delay in language expression.Spastic quadriplegia,ataxia,dyskinetic and mixed types of CP were mainly associated with moderate and severe dyskinesia: 88.89%,75.00%,91.67%,71.43% delay in language development respectively.The children with dyskinetic and mixed types of CP had obviously better language reception than expression (P<0.05 for all),however,delay in language reception and expression was fair.There was a positive correlation between language retardation rate and GMFCS levels in children with CP (r=0.402 and 0.389 for language reception and expression respectively,P<0.01).Conclusions:Language reception and/or expression retardation are common in children with CP and the incidence and severity are also associated with CP types as well as the GMFCS levels.Planning appropriate language therapeutic intervention is therefore vital,especially for children with spastic quadriplegia,dyskinetic,mixed types of CP and those with GMFCS levels of Ⅲ to V.
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