山东省中北部地区肢体残疾儿童现状分析及干预性治疗  

A survey and related intervention on physical handicapped children in the central and northern Shandong

作　　者：林永杰 王国伟 耿震 石恩东 苏文珍 王炳臣 LIN Yong-jie;WANG Guo-wei;GENG Zhen;Sill En-dong;SU Wen-zhen;WANG Bing-chen(Department of Orthopedics,The Third Shandong Provincial Hospital,Jinan 250031,China)

机构地区：[1]山东省立第三医院骨科,山东济南250031

出　　处：《中国矫形外科杂志》2018年第14期1292-1295,共4页Orthopedic Journal of China

摘　　要：[目的]调查山东省中北部地区肢体残疾儿童现状,开展相应肢体残疾预防和针对性治疗。[方法]2012年6月～2017年6月,针对山东省中北部八个地市4 872名残疾儿童进行相关调查。对入选的418名具备手术指征的残疾儿童进行针对性手术治疗,术后30 d给予常规功能锻炼。术后第3个月给予为期60 d的系统康复训练。采用粗大运动功能测试量表(GMFM)评估疗效。[结果]受调查患儿多为轻或中度肢体残疾,占64.43%(3 139/4 872)。致残病因排名前3位的分别是:脑性瘫痪(36.14%)、发育畸形或发育障碍(21.65%)、各种外伤(16.76%)。4 872名残疾儿童中,90.25%由父母监护,65.70%接受义务教育,74.33%既往接受康复服务,92.04%参加医保,78.28%的家庭渴望医疗救助。GMFM包括总分以及站立位、行走与跑跳两个功能区得分,系统康复训练开始时得分显著高于术前,差异有统计学意义(P<0.05);系统康复训练结束时得分显著高于术前和康复训练开始时,差异有统计学意义(P<0.05)。[结论]肢体残疾患儿现状仍有进一步改善空间,针对性手术结合术后系统康复训练能有效提高患儿肢体粗大运动功能。[Objective] To check the current situation of physical handicapped children in the central and northern Shandong, and carry out preventive and targeted treatment for physical disability. [Methods] From June 2012 to June 2017, a survey was conducted on 4 872 physical disabled children in eight prefecture-level cities of the central and northern Shandong. Targeted surgical treatments were given to 418 disabled children who had proper indications, followed by a 30-day routine rehabilita- tion exercise after surgery. At 3 months after operation, a 60-day systematic rehabilitation training was added. The Gross Motor Function Measure （GMFM） was used for evaluation of the consequences. [Results] Most of the children surveyed in this study suffered from mild or moderate physical disabilities, accounting for 64.43% （3 139/4 872）. Three leading causes of physical disabilities were cerebral palsy （36.14%）, developmental deformities or developmental disorders （21.65%） and various traumas （16.76%）. Among the 4 872 disable children, 90.25% of them were supervised by parents, 65.70% were receiving compulsory education, 74.33% had previously received rehabilitation services, 92.04% had health insurance and 78.28% of families were eager to medical treatment respectively. The GMFMs, including total score, the score of standing position and score of walking and running jump, at the beginning of systematic rehabilitation training were significantly higher than those before operation （P〈 0.05）, while the scores at end of the systematic rehabilitation training were significantly higher than those at beginning of systematic rehabilitation training （P〈0.05）. [Conclusion] The current status of physical disable children still leaves room for further improvement. The combined operation with postoperative rehabilitation training does effectively improve the gross motor function of the handicapped limbs.

关 键 词：肢体残疾 儿童 调查 粗大运动功能测试量表(GMFM) 

分 类 号：R687[医药卫生—骨科学]