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.纳入标准智商均低于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4.91.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SPSS10.0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.

Etiological analysis of 613 disabled children with mental retardation

BACKGROUND: There are about 20 millions people suffering from mental retardation in China and about 200 thousands newborns of mental retardation are born every year. Mental retardation in children is a result of multiple factors.OBJECTIVE: To explore the popular causes of mental retardation in order to provide scientific evidence for effectively preventing mental retardation.DESIGN: An observational case study taking children with mental retardation as the subjects.SETTING: Population and family plan institute of a hospital.PARTICIPANTS: Totally 1 336 disabled children in 6 counties of Tai' an city diagnosed by family planning authority from January 1998 to December 2001 were selected. Inclusive criteria: intelligence quotient(IQ) < 55 and met the condition of disabled children, aged over 4 years old, those whose parents requested to give birth to the second baby due to mental retardation of the first children. Exclusive criteria: Disabled children with diseases of other systems. A total of 613 disabled kids met the above standards, aged from 4 to 14 years old, including 509 boys and 104 girls with the ratio of boy to girl of 4.9 to 1.INTERVENTIONS: All the children with mental retardation were examined by professional pediatrists and experts of family planning medical appraisal and conducted IQ test by using Chinese Wechsler Intelligence Scale for Children(C-WISC). Uniform survey was made according to all the data and processed by SPSS10. 0.MAIN OUTCOME MEASURES: The main factors caused mental retardation in kids.RESULTS: Among the 1 336 disabled kids in Tai' an city, the incidence rate of mental retardation was 45.88%. There were 112 mild cases and 501 severe cases with mental retardation among the 613 disabled kids. The component ratio of etiological classification on prenatal, perinatal and postnatal factors was 36.7%, 29.85% and 13.21% respectively, and 20. 23% of them were caused by unclear reasons.CONCLUSION: It is the key mean to prevent the occurrence of mental retardation by reinforcing maternal health, improving obstetric quality, preventing acquired disease and paying attention to early education.