智力低下病残儿613例病因分析

背景：中国目前约有智力低下者2000万，且每年约有20万智力低下新生儿出生。导致儿童智力低下为多种因素作用结果。目的：探讨智力低下的常见病因，为有效预防智力低下提供科学依据。设计：观察性研究，以患儿为研究对象的病例分析。单位：一所医院的人口与计划生育学院。对象：1998—01／2001—12泰安市辖六个县市区经计划生育医学鉴定的病残儿1336例。纳人标准：智商均低于55，符合病残儿条件，年龄大于4周岁。父母要求生二胎的智力低下患儿。排除标准：其他系统疾病的病残儿。符和上述标准的613例病残儿，年龄为4～14周岁。其中男509例，女104例，男女比例为4．9：1。干预：所有智力低下患儿均由专职儿科临床医师及市级计划生育医学鉴定组专家先后进行检查，并按中国修订韦氏儿童智力量表(C-WISC)进行智商测验。在进行资料分析时自制了统一调查表，所得全部数据均经SPSS 10．0统计软件包处理。主要观察指标：导致儿童智力低下的主要因素结果：泰安市1336例病残儿中，智力低下的发生率为45．88％。613例智力低下患儿中轻型112例，重型501例。在病因分类中产前、产时、产后因素分别占其构成比的36．7％、29．85%和13．21％，有20．23％原因不明。结论：加强孕期保健，提高产科质量，积极防治后天获得性疾病，重视小儿的早期教育是预防智力低下的关键。     

病残儿121例医学鉴定结果分析

目的 通过病残儿医学鉴定总结分析,掌握本县病残儿的疾病,种类、病因,为优生优育制度有效预防措施.方法 根据国家计生委《病残儿医学鉴定管理办法》及《病残儿医学鉴定诊断标准及其父母再生育指导原则》,对清新县1992～2006年上报的121例病残儿资料进行审查分析.结果 脑瘫和智力低下35例,占28.92%;出生缺陷91例,占75.20%;后天致残21例,占17.36%.结论 要提高出生人口素质,避免出生缺陷儿,必须普及优生优育知识,开展孕前筛查,加强围产期保健监护.     

儿童癫痫大发作132例智力障碍分析

目的探索儿童癫痫大发作的智力障碍程度和结构特点。方法选取驻马店市计划生育病残儿医学鉴定132例城市儿童癫痫大发作患儿,采用中国修订韦氏儿童智力量表(C-WISC)进行智商测验,对智力障碍程度和智力结构特点进行分析,并和对照组98例驻马店市某小学6～14岁的学生进行比较。结果两组低智商发生率差异有极显著性意义(χ2=151.56,P<0.005);两组言语智商、操作智商和总智经t检验,差异均极显著(t=17.496,23.974,P均<0.001)。132例儿童癫痫大发作的智力障碍发生率高达81.8%(108/132),各分测验年龄量表分的均分与正常儿童均分(10)相比均超过了一个标准差(3),其中图片排列(3.1±3.8)、木块图(3.2±3.3)和分类测验(3.4±4.1)三项分测验量表分超过了两个标准差(6)。结论儿童癫痫大发作是导致儿童智力障碍的重要因素,所致智力障碍的结构特点是在全面智力受损的同时,上述三项分测验所负荷的智力因素受损更明显。     

智力低下儿童468例致病因素分析

1对象与方法1.1对象研究对象为驻马店市九县一区1993年～2001年5月计划生育医学鉴定中共计468例智力低下(MR)儿童。对照组为我驻马店市农村、城市幼儿园和小学1～5年级116例学生中材料完整的98例儿童。1.2方法首先由取得测验资格的临床医师对MR儿童进行中国修订韦氏儿童智力量表(C-WISC)和中国-韦氏幼儿智力量表(C-WYCSI)测验。然后由鉴定组的两位或3位神经精神科医师依据中国精神疾病分类方案及诊断标准(CCMD-2-R)共同鉴定、结论。对导致智力低下的致病因素按生物学因素和家庭社会文化因素进行调查。所有调查内容均按自制的统一调…     

上海市虹口区83例病残儿病因分析及干预措施探讨

目的:分析虹口区1998年7月～2007年5月申报生育二胎的83例病残儿的病因,探讨预防和减少病残儿发生的干预措施,从而降低病残儿的发生率。方法:对83例其父母申报生育二胎的病残儿鉴定资料进行分析。结果:83例病残儿中,智能低下居首位(25例,占30.12%),脑瘫居第二位(9例,占10.84%),肿瘤居第3位(8例,占9.64%),居第四位的是先天性心脏病(7例,占8.43%)。其中,先天疾病致残的22例,占26.51%,以先天性心脏病和先天性耳聋为多;后天疾病致残的61例,占73.49%,以智能低下占居首位,智力低下病残儿中大部分有胎窘及重度窒息抢救史。结论:加强婚前咨询及孕前、孕期监测和产前的筛查;提高产科质量,加强产程观察,减少胎儿宫内窘迫及新生儿窒息的发生;重视疾病预防;加强环境保护等是减少残疾儿发生的有效措施。     

172例智力低下病残儿病因分析

分析 172例智力低下病残儿病因及产生机理 ,对其家庭进行优生指导。     

痉挛型双瘫脑性瘫痪患儿智力水平及智力结构分析

目的探讨痉挛型双瘫脑瘫患儿智力水平及智力结构情况。方法采用中国韦氏幼儿智力量表和中国韦氏儿童智力量表对67 例痉挛型双瘫脑瘫患儿(分低龄组、高龄组)进行测试。结果低龄组(≤6 岁5 个月)患儿平均总智商(71.10±15.95),高龄组(>6 岁5 个月)平均总智商(73.12±16.02),总智力低下率44.78%,低于脑瘫患儿的平均智力低下率。高龄组言语智商明显优于操作智商(P<0.01),Bannatyne 四因素中概念因素和获得因素的分测验得分高于空间因素和序列因素分测验(P<0.05)。结论痉挛型双瘫脑瘫患儿智力水平落后,但优于脑瘫患儿的平均智力水平,其智力结构存在不均衡现象。     

儿童癫痫大发作132例智力障碍分析

目的 探索儿童癫痫大发作的智力障碍程度和结构特点。方法 选取驻马店市计划生育病残儿医学鉴定132例城市儿童癫痫大发作患儿，采用中国修订韦氏儿童智力量表(C—WISC)进行智商测验，对智力障碍程度和智力结构特点进行分析，并和对照组98例驻马店市某小学6～14岁的学生进行比较。结果 两组低智商发生率差异有极显著性意义(χ^2=151．56，P&;lt;0．005)；两组言语智商、操作智商和总智经t检验，差异均极显著(t=17．496，23．974，P均&;lt;0．001)。132例儿童癫痫大发作的智力障碍发生率高达81．8％(108／132)，各分测验年龄量表分的均分与正常儿童均分(10)相比均超过了一个标准差(3)，其中图片排列(3．1&;#177;3．8)、木块图(3．2&;#177;3．3)和分类测验(3．4&;#177;4．1)三项分测验量表分超过了两个标准差(6)。结论 儿童癫痫大发作是导致儿童智力障碍的重要因素，所致智力障碍的结构特点是在全面智力受损的同时，上述三项分测验所负荷的智力因素受损更明显。     

结节性硬化症13例分析

[目的]评价结节性硬化症的临床特征和CT、MRI对其诊断价值.[方法]对13例结节性硬化症患儿的临床资料进行回顾性分析.[结果]13例患儿的临床特征为：起病年龄均在3岁以内占100%,除一例患儿外其余均以癫痫发作为首发症状,有皮肤表现者9例占69.2%,均表现为色素脱失斑.智力低下者9例占69.2%,全部患儿均有脑CT或MRI改变.[结论]癫痫、特殊的皮肤损害、智力低下为本病的主要临床特征：脑CT或MRI检查有助于明确诊断.     

97例唐氏综合征的临床表现及细胞遗传学分析

唐氏综合征 (Down syndome,DS)又称先天愚形 ,2 1三体综合征。是当今全球发病率最高的新生儿严重缺陷之一 ,发病率 0 .1% ,无明显地域差异。病因是生殖细胞形成过程中 ,减数分裂时 2 1号染色体发生不分离造成的。 1994年 5月～1999年 11月 ,我院检出 97例报告如下。1　资料与方法1.1　一般资料　 97例 DS患儿中男 6 7例 ,女 30例 ;母亲年龄 >35岁者 12例 (12 .4% ) ,<35岁以下者 85例 ,(87.6 % )。1.2　智力低下分级　按 IQ及社会适应能力划分为四级 ,本组分级见表 1。智力诊断 :0～ 3岁采用盖塞尔量表 ;4～ 6岁采用中国韦氏儿童智力量表…     

613例语言障碍儿童临床分析

目的了解儿童语言障碍的临床特点。方法通过采集病史、听力和语言检查、智力测试等方法对 613例语言障碍儿童进行评定 ;采用门诊语言训练和家庭语言训练结合的模式对语言障碍儿童进行治疗。结果本组 613例受检儿童中 ,语言发育迟缓 3 75例 (60 .2 0 % )、构音障碍 193例 (3 1.48% ) ,门诊语言治疗 5 8例均收到预期的临床效果。结论语言发育迟缓和构音异常是儿童语言障碍的主要问题 ;儿童时期是语言障碍的好发时期 ,也是矫治语言障碍的关键时期     

北京市发育障碍儿童康复及其影响因素调查

目的了解发育障碍儿童接受康复的情况及其影响因素。方法采用问卷调查法调查北京市残疾儿童调查中确定的三类发育障碍儿童269人,其中智力组237人、肢体组57人、精神组26人。结果智力组从未接受过康复训练/医疗的比例为71.31%;肢体组为33.93%;精神组为42.31%;康复服务主要集中在功能训练和医学治疗方面,心理咨询等服务极少;发育障碍儿童是否采取康复的影响因素包括独生子女与否(P<0.01)、母亲年龄(P<0.001)、母亲文化程度(P<0.05)、父母是否知道发育迟缓儿童需早期干预(P<0.001)、合并残疾种类数(P<0.001)等。结论影响残疾儿童康复的影响因素很多,应该对贫困家庭采取康复救助政策,当务之急是加强康复服务方面的健康教育,对残疾人及其家属开展康复知识普及服务。     

小儿脑瘫智能评定研究

目的 改进脑瘫患儿合并智能障碍的评定，充分发挥患儿的智力水平，防止造成患儿2次精神心理障碍。方法 对107例脑瘫患儿进行康复前后的智力测定，作出智障诊断并采用综合手段全面康复治疗1个疗程（3个月）。结果 220例脑瘫患儿中合并智力障碍164例，占74．5％；重度脑瘫儿合并智障者高达90%，康复显效患儿合并智障的比例低。结论 影响脑瘫患儿智力评定的因素很多，应综合判断分析，寻求更合理的评定方法。     

福利院残疾人生活自理能力行为训练效果观察

目的 :观察福利院残疾人实施生活自理能力行为训练的效果。方法 :按病种随机将 6 6例残疾人分为训练组 32例 ,对照组 34例 ,均为男性 ,训练组用行为纠正方法进行训练 ,内容包括 :基本生活自理能力 (如吃饭、二便、起居 )及社交能力 ,用日常生活能力量表评定疗效。对照组采用传统护理方法。结果 :训练 2个月后开始起效 ,到 6个月训练结束时效果最好 ,训练后 2组差异有高度显著性 (P <0 0 1)。结论 :用行为纠正方法训练福利院残疾患者效果良好 ,生活自理能力显著提高     

Evaluating Acquiescence to Yes–No Questions in Fear Assessment of Children With and Without Mental Retardation

The study examined the acquiescence response set (ARS) to yes–no questions in fear survey assessment of 75 children with mental retardation (ages 10–13 years) and 240 children without mental retardation (ages 6–13 years). The items used to assess the ARS were 10 stimuli, as part of a fear survey, with design features that are consistent with ARS assessment recommendations made by Finlay, W. M. L., and Lyons, E. (2002, Mental Retardation 40:14–29). In contrast to findings of seminal ARS studies by Sigelman and colleagues, the main finding was that there were no significant cognitive group differences in ARS scores. Additionally, for children with mental retardation, there was no significant relationship between IQ and ARS scores (r = −.16).Implications of the study are discussed. An erratum to this article is available at .     

A sensorimotor program for improving writing readiness skills in elementary-age children.

This article discusses a writing readiness program used with three groups of children aged 5 to 7 years. The program combines occupational therapy treatment with a supplementary program implemented by school personnel or parents. The Developmental Test of Visual-Motor Integration-Revised (Beery, 1982) was used to measure the developmental level of the children's writing readiness skills before and after treatment. The group of children with a significant verbal performance IQ discrepancy (greater than 15 points) showed a 17-month growth in readiness skills within 1 year. The group of children with mental retardation (IQ less than 80) showed a significant sex effect: The boys showed more gains than the girls. Implications of these findings are discussed.     

广州、东营两市7～18岁残疾儿童生长发育状况调查

目的了解广州、东营两市7～18岁残疾儿童(肢体残疾除外)的生长发育现状。方法采用定点普查的方法,对广州、东营两市7～18岁残疾儿童进行调查,通过测量残疾儿童身高和体重等指标,反映残疾儿童的生长发育现状。结果与同龄正常儿童相比,残疾儿童的身高、体重等普遍偏低,残疾儿童消瘦率男性为12.61%、女性为12.54%,生长迟滞率男性为31.41%、女性为34.49%。结论我国7～18岁残疾儿童生长发育状况较差,消瘦率和生长迟滞率均较高。     

Impact of chronic illness in children on parental living conditions. A population-based study in a Swedish primary care district.

In a geographically defined child population aged 0-15, every twelfth child suffered from chronic illness. Their parents and randomly selected control children's parents were asked about their living conditions using questionnaires. Non-responders (30%) had the same sociodemographic profile as responders. The socioeconomic level in index families (n = 95) was lower than in control families (n = 166). Both parents worked fewer hours in index than in control families. Index mothers had more health problems and sick days than control mothers. The parents' social relations were most hampered by having children with allergic disorders or mental retardation. Despite reduced hours, more absence from work to care for sick children, and reduced leisure activities, two thirds of the parents of moderately/severely disabled children found it difficult to cater adequately to the needs of their child. A family approach is recommended to provide comprehensive care of children with chronic illness, in which both specialized and primary care are needed.     

To what extent are the needs of severely disabled people met by community rehabilitation services? A follow-up study

Purpose : To evaluate which needs of disabled people would be met over a one year follow-up period and to examine which factors would be predictive of identifying those people who had more needs met from those who had fewer needs met. Method : A follow-up study of a cohort of community dwelling disabled people (aged 16-65) from two NHS Health Districts in Southern England with contrasting patterns of rehabilitation provision, who had participated in a cross-sectional interview study one year previously which had assessed their met and unmet needs. The Southampton Needs Assessment Questionnaire was used to examine needs. Disability was evaluated with the OPCS Disability and Severity Scales and perceived health status with the SF-36. Results : Participation rate at follow-up was 92%. Of the 300 baseline unmet needs reported by 69 of the 77 participants 33% had been met at follow-up. People whose disability had increased more and/or whose mental health status had improved more had greater percentages of their baseline needs met. There was a non-significant trend for smaller percentages of baseline needs to be met in Basingstoke than in Southampton. Conclusions : At ground level, disabled people's views were taken into account, to some extent, in the provision of rehabilitation services. This input should be made at a higher level, in the overall shaping of services.     

To what extent are the needs of severely disabled people met by community rehabilitation services? A follow-up study

Purpose: To evaluate which needs of disabled people would be met over a one year follow-up period and to examine which factors would be predictive of identifying those people who had more needs met from those who had fewer needs met. Method: A follow-up study of a cohort of community dwelling disabled people (aged 16-65) from two NHS Health Districts in Southern England with contrasting patterns of rehabilitation provision, who had participated in a cross-sectional interview study one year previously which had assessed their met and unmet needs. The Southampton Needs Assessment Questionnaire was used to examine needs. Disability was evaluated with the OPCS Disability and Severity Scales and perceived health status with the SF-36. Results: Participation rate at follow-up was 92%. Of the 300 baseline unmet needs reported by 69 of the 77 participants 33% had been met at follow-up. People whose disability had increased more and/or whose mental health status had improved more had greater percentages of their baseline needs met. There was a non-significant trend for smaller percentages of baseline needs to be met in Basingstoke than in Southampton. Conclusions: At ground level, disabled people's views were taken into account, to some extent, in the provision of rehabilitation services. This input should be made at a higher level, in the overall shaping of services.