1~12岁脑瘫伴癫痫患儿综合康复治疗现状及相关因素分析  

Analysis of Comprehensive Rehabilitation Treatment and Related Factors in 1-12-Year-Old Children with Cerebral Palsy and Epilepsy

作　　者：施慧玲 温壮飞 刘颖[1] SHI Huiling;WEN Zhuangfei;LIU Ying(Department of Pediatrics,Haikou Maternal and Child Health Hospital,Haikou 571100,China;Department of Pediatric Rehabilitation,Haikou Maternal and Child Health Hospital,Haikou 571100,China)

机构地区：[1]海口市妇幼保健院儿保科,海口571100 [2]海口市妇幼保健院儿童康复科,海口571100

出　　处：《临床误诊误治》2023年第7期138-143,共6页Clinical Misdiagnosis & Mistherapy

基　　金：海南省自然科学基金项目(821MS0848)。

摘　　要：目的 分析1~12岁脑瘫伴癫痫患儿综合康复治疗现况及其相关因素。方法 选取2017年1月—2021年12月220例1~12岁脑瘫伴癫痫患儿进行一般资料、病例资料及综合康复治疗效果采集,通过多因素Logistic回归分析探讨综合康复治疗效果的影响因素,绘制森林图,构建预测综合康复效果的风险预警模型,受试者工作特征曲线分析风险预警模型的预测价值。结果 最终纳入218例脑瘫伴癫痫患儿,经综合康复治疗后显效94例(43.12%)、有效102例(46.79%)、无效22例(10.09%)。放弃治疗、惊厥持续时间、头颅影像阳性、短式亲职压力量表评分是脑瘫伴癫痫患儿综合康复效果的危险因素(P<0.01),而了解疾病、家属疾病认知度评分、领悟社会支持量表评分、康复治疗依从性评分是保护因素(P<0.01)。风险预警模型预测脑瘫伴癫痫患儿综合康复效果的曲线下面积为0.931(95%CI:0.888,0.961),敏感度为86.36%,特异度为86.22%。家庭负担沉重、对疾病预后产生怀疑是脑瘫伴癫痫患儿家属选择放弃治疗的主要原因,分别占55.17%(16/29)、24.14%(7/29)。结论 对脑瘫伴癫痫患儿综合康复效果的影响因素进行分析,及时构建预测模型进行高危人群识别,并尽早采取针对性干预措施至关重要。Objective To analyze the status of comprehensive rehabilitation treatment and related factors in children aged 1-12 years with cerebral palsy and epilepsy.Methods From January 2017 to December 2021,220 children with cerebral palsy and epilepsy aged 1 to 12 years old were selected to collect general data,case data and comprehensive rehabilitation treatment effect.The influencing factors of comprehensive rehabilitation treatment effect were analyzed by multivariate Logistic regression analysis,and forest map was drawn to build a risk warning model for predicting comprehensive rehabilitation effect.The predictive value of the risk warning model was analyzed by receiver operating characteristic(ROC) curve.Results Ultimately,218 children with cerebral palsy and epilepsy were included in the study.Comprehensive rehabilitation treatment was significantly effective in 94 cases(43.12%),effective in 102 cases(46.79%),and ineffective in 22 cases(10.09%).Treatment abandonment,duration of convulsion,positive head image and short-form parental stress scale score were risk factors for comprehensive rehabilitation effect of children with cerebral palsy and epilepsy(P<0.01),while understanding the disease,family disease recognition score,understanding social support scale score and rehabilitation treatment compliance score were protective factors(P<0.01).The area under the ROC curve of the risk warning model for predicting the comprehensive rehabilitation effect in children with cerebral palsy and epilepsy was 0.931(95%CI:0.888,0.961),sensitivity was 86.36%,and specificity was 86.22%.Heavy family burden and doubt about the prognosis of the disease were the main reasons for families of children with cerebral palsy with epilepsy to give up treatment,accounting for 55.17%(16/29) and 24.14%(7/29) respectively.Conclusion It is very important to analyze the factors influencing the comprehensive rehabilitation effect of children with cerebral palsy and epilepsy,build a predictive model in time to identify high-risk groups,and take targe

关 键 词：脑瘫 癫痫 儿童 综合康复 社会支持 危险因素 受试者工作特征曲线 停止治疗 

分 类 号：R748[医药卫生—神经病学与精神病学]