浅析社会工作介入在儿童福利机构脑瘫儿童康复治疗中的应用

脑瘫儿童康复治疗工作备受关注,脑瘫病症一旦在儿童身上出现,会对患儿自身及儿童福利机构带来沉重压力。儿童福利机构脑瘫儿童康复期间,社会工作及时介入,一定程度上为儿童福利机构提供支持,因为工作人员凭借专业知识及技能帮助脑瘫儿童早日康复,促进患儿身心健康发展。文章通过阐述儿童福利机构运用社会工作方法介入脑瘫儿童康复治疗的情况,分析具体工作中存在的问题,提出改进思路,从而提高脑瘫疾病治疗质量,提升孤残儿童幸福指数。     

异常出生体重与儿童青少年神经行为发育的研究进展

异常出生体重不仅会影响新生儿的体格生长,还会对婴儿期、儿童青少年期甚至成年期的神经行为发育产生影响。本文从低出生体重儿和巨大儿两方面就异常出生体重对儿童青少年神经行为发育影响的人群研究进行综述,结果发现,低出生体重儿比正常出生体重儿在儿童青少年期更易发生脑瘫、注意缺陷多动障碍、认知障碍和学习能力低下等问题。巨大儿会增加儿童青少年的运动功能、情绪行为发育异常的发生风险,但巨大儿与儿童青少年的智商/认知功能和学业成绩间的关联性研究结论尚不一致。要明确异常出生体重对儿童青少年神经行为发育的影响程度,还需进一步开展大样本的前瞻性队列研究。     

重视儿童饮食行为问题对胃肠功能的影响

饮食行为是诸多行为的一种,不仅会直接影响到儿童膳食营养的摄入,还会影响他们的学习表现和体能。随着社会经济的飞速发展,我国儿童少年的膳食营养摄入和健康状况都有了很大的改变,膳食营养质量明显改善,营养不良显著降低。但与此同时,由于膳食模式和生活方式的转变,以及独生子女群体的出现,儿童饮食行为问题越来越多的受到家长和医护人员的重视,发现儿童饮食行为异常影响儿童的胃肠功能,导致消化吸收不良,直接影响儿童的身心发育及健康成长,因而应重视儿童饮食行为问题对胃肠功能的影响,及时发现饮食行为问题,评估其对胃肠功能的影响,进行早期干预或治疗,对于儿童健康成长无疑是非常重要的。     

脑瘫儿童早期运动发育迟缓及运动方式异常的研究

从农村地区抽样调查获得的９７名１～８岁脑瘫儿童及与患儿同一行政村选取的１２８名对照儿童的早期运动发育和异常运动方式进行回顾性调查。结果显示,脑瘫儿童早期运动和言语发育迟缓,检出率显著高于对照儿童,一些异常运动方式仅见于脑瘫儿童,病情愈重的脑瘫儿童早期发育迟缓和运动方式异常项目愈多。提示基层妇幼保健和临床医生应对儿童早期异常运动方式和发育迟缓与脑瘫的关系予以关注。     

脑瘫儿童主观全面营养评估方法的临床研究

目的 研究主观全面营养评估(SGNA)和儿童生长发育Z评分临床应用于脑瘫儿童营养不良状况评估的一致性,为SGNA的临床应用推广提供有效参考.方法 对于2021年1-7月就诊于安徽省儿童医院康复科的76例脑瘫儿童,分别进行SGNA评估和儿童生长发育Z评分测量,评估其营养不良状况,并使用加权Kappa系数分析SGNA与Z评...     

本体感觉评估在脑瘫儿童中的应用

感觉功能障碍是脑瘫儿童普遍存在的临床问题,其中本体感觉在运动过程中对于姿势的调整,平衡协调的维持方面发挥重要作用,因此,针对脑瘫儿童进行本体感觉的评估对于未来的康复具有重要意义,但是目前关于本体感觉的研究还很缺乏,其主要应用于脑卒中、关节损伤等成年人群体。因此本文旨在整理国内外针对脑瘫儿童特殊群体的本体感觉评估进行综述。     

重视营养素对儿童神经发育及行为的调控影响

营养是保证小儿正常生长发育、身心健康的重要因素.儿童早期的营养状况会影响其一生的健康,同时也从一个方面代表着一个国家的经济发达程度.营养不仅对儿童的生长发育起重要作用,而且与儿童的神经发育、行为发育存在着密切关系.甚至一些营养素的轻度缺乏,亦会对儿童的神经发育和行为造成有害影响.无论是三大营养索、还是矿物质和维生素.通常是在体内被消耗尽后,该营养素缺乏症状才能表现出来.但常在一些营养素哑临床状态缺乏时,就会影响到儿童的生长和行为发育,却往往不能被临床医生所认识,此时已经构成对儿章健康的早期危险因素.     

脑瘫儿童共病骨折的病因和干预措施

脑瘫儿童常伴有继发性肌肉骨骼问题,其中骨折的发病率较高,症状较重,是严重影响脑瘫儿童康复进程不可忽视的因素之一。本文将从低骨密度、训练异常、早产、跌倒等角度阐述脑瘫儿童发生骨折的原因,并对改善骨密度和运动训练等干预措施进行总结,以期为预防和治疗脑瘫儿童发生骨折的临床工作提供帮助。     

2 472名学龄前儿童龋齿发病情况调查

龋齿是一种危害儿童健康最普遍的疾病。儿童患龋齿后 ,不仅会因局部疼痛影响食物咀嚼及营养吸收 ,而且还常会诱发某些全身性疾病。为了解我县学龄前儿童龋齿患病情况 ,我们对本县城区 0～ 6岁学龄前儿童龋齿患病情况作了调查 ,结果报告如下。1　材料与方法　　调查对象为县城 7     

“健脾生血冲剂”是治疗小儿贫血的良药

我国近十二亿人口。其中三分之一约为14岁以下儿童。儿童中患有贫血者众多,有40％左右,农村中可高达60％左右。患贫血的儿童,不仅体弱多病,重者更会影响体格生长和智能发育。儿童所患的贫血中尤以缺铁性贫血最多见,常系营养不足、经常患病等引起。因此,防治小儿贫血,仍为儿童保健的主要内容之一,也是广大儿科医生和家长们关注的问题。目前市售武     

脑瘫儿童营养与免疫因子检测及个体化营养干预效果研究

目的 通过应用人体测量法对脑瘫患儿的营养状况进行评估,并测定体液免疫因子,分析其与营养状况的相关性,为临床实施个体化营养服务提供参考。方法 选择2018年3月-2019年3月在郑州大学第三附属医院儿童康复科住院治疗的1~5岁脑瘫患儿为研究对象,用Z评分法评价患儿的营养状况,并测定其体液免疫因子,通过加强患儿营养治疗干预后,检测患儿各项指标的改善情况。结果 共纳入90例脑瘫患儿进行营养评估并行个体化营养干预,其营养状况不容乐观,营养不良发生率为53.3%(48/90),其中低体重率为33.3%,生长迟缓率为54.2%,消瘦率为20.8%,超重或肥胖率为16.7%;轻、中、重度脑瘫患儿的体重、WAZ、体液免疫因子IgG和IgM差异均有统计学意义(F=3.321、3.964、16.955、5.596,P＜0.05);干预后体重、WAZ高于干预前,差异具有统计学意义(t=2.236、2.280,P＜0.05)。结论 脑瘫患儿营养不良及营养性疾病发生率较高,病情严重程度越重,营养状况越差,体液免疫因子IgG、IgM水平越低。个体化营养干预可改善患儿的近期营养状况。     

脑瘫患儿生命质量流行病学研究进展

脑瘫患儿生命质量在近20年引起研究者广泛关注。对国内外近10年该领域流行病学研究进行综述，主要介绍了脑瘫患儿生命质量现况及影响因素的最新进展。开展大规模、基于人群的流行病学研究，寻找影响脑瘫患儿生命质量的主要因素，加强纵向研究是我国该领域未来研究的趋势。     

The impact of feeding problems on growth and energy intake in children with cerebral palsy.

Retrospective data on growth and cross-sectional data on growth outcome, anthropometric measurements and energy intake have been analysed according to the presence or absence of feeding problems in 42 children with cerebral palsy (CP) between 1 and 13 years of age. The mean age for boys and girls was 5.1 and 5.9 years, respectively. The study revealed a high frequency of feeding problems (50%) and growth retardation (48%) in the group. The results of weight for height, triceps skinfold thickness and energy intake indicate that 15% of the children were undernourished at the time of study. The cross-sectional analyses showed that children with feeding problems at the time of study (n = 22) had significantly lower height for age, weight for height, triceps skinfold thickness and upper-arm circumference than children without problems (P less than 0.05). Children with feeding problems also tended to have lower energy intake, but the differences were not significant. The feeding problems were most frequent among the severely disabled children. This study has shown that the presence of feeding problems is one important predictor of low growth outcome in children with CP. When parents report on feeding problems, feeding evaluation, training and nutritional intervention should be offered immediately. This is important for alleviating the heavy care-load for parents and health-workers and for some children it may be necessary to maintain an acceptable nutritional state.     

小儿脑瘫患者与正常婴幼儿各50例头发35种元素检验结果比较

小儿脑瘫即小儿中枢性神经脑瘫痪，目前发病率有增无减，而且尚无有效治疗方法，因此，对小儿健康造成极伤害，给家庭和社会带来巨大负担。笔者通过头发检验研究发现小儿脑瘫类似于成人脑中风及其后遗症。笔者报告50例小儿脑患者与正常小儿头发35种元素检验结果用t-检验，成对双样本均值分析进行比较27种元素。发现：脑瘫患儿发中Ti、Fe、Pb、La、Cr、Mn、Mg、Al、Sr、Zr等10种元素高于正常儿具有显著性差异，呈正相关。用元素医学食疗法治疗小儿脑瘫获得成功，小儿越小治疗效果越好，2岁以内治愈率85％以上，2—4岁治愈率75％，4-6岁治愈率56％，6-8岁治愈率不到30％，8岁以上只能增智而无法治愈。     

Feasibility of bioelectrical impedance analysis in children with a severe generalized cerebral palsy

OBJECTIVE: The need is strong for an accurate and easy-to-perform test to evaluate the nutritional state of children who have a severe generalized cerebral palsy, defined as a severe motor handicap and an intellectual disability. For that purpose, we determined the feasibility of bioelectrical impedance analysis (BIA) in these children and evaluated their nutritional state. METHODS: BIA recordings were done in 35 children who had a severe generalized cerebral palsy using a single-frequency BIA device. In addition, arm span and body weight were determined. Components of feasibility were whether the children tolerated the recording and felt comfortable and whether the recording could be performed in a reproducible way (prescribed body position and stable resistance and reactance values). All recordings were performed at specialized children's daycare centers or schools. RESULTS: One child (3%) did not tolerate the recording, whereas the remaining 34 children (71%) felt comfortable. Most children (74%) could be placed in the prescribed position, but stability of resistance values was low. Stability of resistance values was positively influenced by older age, a quiet location for the recording, feeling comfortable, and a small number of people in the room. For 29 children, we were able to calculate values for total body water and fat-free mass. Compared with age-matched reference values, these values were significantly decreased in all age groups. CONCLUSIONS: The present pilot study has demonstrated that BIA recording is a feasible nutritional assessment method in children who have severe generalized cerebral palsy. Because the test procedure was well tolerated by most children, its value for use in this specific population deserves further investigation.     

学龄前脑性瘫痪儿童149例营养状况调查分析

目的 探讨学龄前脑性瘫痪儿童的营养不良状况及其与临床分型、分级之间的关系。方法 测量149例0～6岁脑性瘫痪住院患儿的身高、体重、血红蛋白值,计算其低体重、发育迟滞、消瘦及贫血率;并分析营养不良各项指标与脑瘫类型、临床分型、粗大运动功能分级(Gross Motor Function Classification System,GMFCS)之间的关系。与正常学龄前儿童的营养不良状况进行对比。结果 学龄前脑性瘫痪儿童低体重、发育迟滞、消瘦及贫血率分别为:31.54%、33.55%、41.28%、28.85%,其营养不良发生率均明显较正常儿童高。在不随意运动型脑瘫及痉挛型进行比较中,低体重及消瘦组差异存在统计学意义(P<0.05),发育迟缓与贫血在这两个组比较差异无统计学意义(P>0.05)。105例痉挛型脑性瘫痪儿童,其低体重、发育迟缓、消瘦、贫血的发生率分别为:26.6%、31.43%、24.76%、28.57%。营养不良与脑性瘫痪的分级在低体重、发育迟缓及消瘦分组中差异都有统计学意义(P<0.05)。结论 脑性瘫痪儿童的营养不良比正常学龄前儿童明显高。加强其营养不良的干预力度是非常有意义及势在必行的。     

脑性瘫痪儿童伴随交流障碍的影响因素及治疗研究进展

脑性瘫痪(简称脑瘫)是儿童常见的神经系统致残性疾病，姿势发育异常及运动障碍是其核心表现。交流障碍作为脑瘫儿童常见的伴随障碍，具有较高的发病率，对患儿的心理健康及社会交往等造成严重影响。近年来，如何高效地提高脑瘫儿童交流能力是康复治疗的一大重点。而交流障碍由多因素导致，且临床表现多样，进行早期评估及干预尤为重要。本文从脑瘫交流障碍的影响因素、临床特征、评估及治疗等展开综述，为改善脑瘫儿童交流现状提供更多临床思路。     

Sleep problems and the need for parental night-time attention in children with physical disabilities

Background The aim of the study was to investigate the frequency and predictors of sleep problems and the need for parental night‐time attention in children with physical disabilities. Methods A questionnaire on sleep problems and need for parental night‐time attention was completed by 505 parents of children with physical disabilities aged 1–16 years (mean 9 years 3 months) with moderate to severe motor disabilities. General characteristics of the children were analysed by frequencies and cross‐tabulations. Logistic regression analysis was used to identify factors associated with sleep problems and the need for parental night‐time attention. Results The results showed a high prevalence of sleep problems, which in general were chronic. Currently 48% of the children had sleep problems, of which 23% estimated the problems to be serious. About one‐third (37%) needed parental night‐time attention every night, and 10% needed help five times or more. No significant differences were found between younger children and school‐aged children regarding sleep problems and the need for parental night‐time attention. Having pain [odds ratio (OR) = 3.4] was associated with sleep problems, as was having problems eating and drinking (OR = 3) and the diagnosis of cerebral palsy (OR = 2.5) (P < 0.05). Children with muscular dystrophy (OR = 68.5), cerebral palsy (OR = 26.7) and ‘other diagnosis’ (OR = 18.5) were more likely to need support at night than were children with spina bifida, P < 0.001. Pain (OR = 7.6) was also associated with need for support at night, P < 0.001. Conclusions The prevalence of sleep problems and need for parental night‐time attention is high among children with physical disabilities. This in turn affects the whole family, and paediatric caregivers must keep this in mind. Besides certain diagnoses, the results suggest that children who have pain should be prioritized.