维生素D辅助康复治疗对脑瘫伴语言功能障碍患儿的影响研究

目的 分析维生素D辅助康复治疗对脑瘫伴语言功能障碍患儿的临床疗效。 方法 选择2011年3月—2014年6月丽水市中心医院收治的脑瘫伴语言功能障碍患儿共82例，根据入院先后顺序，采用随机数字法将其分为单纯康复治疗组39例和维生素D辅助康复治疗组(联合组)43例，常规康复治疗包括物理治疗、推拿、语言训练等,双鲸维生素D滴剂1粒/次，1次/d,3个月为一疗程，观察患者病情变化;比较2组患儿的语言发育能力、Gesell儿童发育量表和Bayley婴幼儿发展量表评分及维生素D和血钙水平的差异性。 结果 治疗后联合组患儿的语言发育改善程度显著提高，总有效率大于单纯组(95.3% vs. 74.4%，χ2=7.213，P=0.007)，Gesell儿童发育量表发育商数DQ平均得分显著提高[(70.4±11.3)分 vs. (53.3±10.5)分，t=6.127，P=0.026]，正常患儿的比例显著高于单纯组(41.9% vs. 20.5%，F=4.304,P=0.038);Bayley婴幼儿发展量表发育指数优秀比例显著提高(F=9.202，P=0.002)。维生素D和血钙水平比单纯组明显增高，差异均有统计学意义[(78.9±23.8)pmol/L vs. (56.3±21.0)pmol/L，t=6.025，P=0.023；(1.9±0.4)mol/L vs. (1.3±0.1)mol/L，t=5.624，P=0.028]。 结论 维生素D辅助康复治疗可较为有效地改善脑瘫伴语言功能障碍患儿的语言功能及发育状况，有一定的临床应用价值。 

Effect of Vitamin D with rehabilitation on cerebral palsy children with language dysfunction

Objective To investigate the clinical effect of Vitamin D with rehabilitation on the cerebral palsy children with language dysfunction. Methods A total of 82 consecutives cases of cerebral palsy children with language dysfunction in our hospital from March 2011 to June 2014 were divided into purely rehabilitation group(n=39) and Vitamin D assisted with rehabilitation(combined group,n=43) by random number method according to the sequences of arriving into the hospital.The conventional rehabilitation therapy included physical therapy,massage,language training and so on;Shuangjing vitamin D drops were used in the combined group by one pill per-time and per-day,three months as a period.The condition changes of patients were observed.The language development situation,Gesell Child Development Scale,Bayley Infant development scale and serum Vitamin D,calcium levels after three months of treatment were compared between the two groups. Results In combined group,the total efficacy rate of language development situation was significantly higher(95.3% vs. 74.4%,χ2=7.213,P=0.007),the developmental quotient DQ score by Gesell Child Development Scale was higher[(70.4±11.3) vs.(53.3±10.5),t=6.127,P=0.026],the normal children rate was significantly more (41.9% vs. 20.5%,F=4.304,P=0.038);the excellent ratio of development index by Bayley Infant development scale was better (F=9.202,P=0.002),and the levels of serum Vitamin D and calcium were significantly higher[ (78.9±23.8) pmol/L vs.(56.3±21.0)pmol/L,t=6.025,P=0.023;(1.9±0.4)mol/L vs.(1.3±0.1)mol/L,t=5.624,P=0.028]. Conclusion Vitamin D with rehabilitation can effectively improve the language function and development in cerebral palsy children with language dysfunction,the clinical value should be further studied.