《中国康复理论与实践》

《中国康复理论与实践》 ›› 2010, Vol. 16 ›› Issue (12): 1169-117.

• 论文 • 上一篇    下一篇

脑瘫患儿吞咽障碍及其与粗大运动功能分级的关系

姜艳平1，侯梅2，窦坦凤3，李文妍3，杨会娟1   

  1. 1.青岛大学医学院2008级康复医学与理疗专业，山东青岛市 266071；2.青岛市妇女儿童医疗保健中心神经康复科，山东青岛市 266011；3.潍坊市妇幼保健院康复中心，山东潍坊市 261011。
  • 收稿日期:2010-09-13 修回日期:1900-01-01 出版日期:2010-12-25 发布日期:2010-12-25
  • 通讯作者: 候梅

Dysphagia in Cerebral Palsy and the Relationship between Levels of Gross Motor Function Classification System

JIANG Yan-ping, HOU Mei, DOU Tan-feng, et al   

  1. Department of Rehabilitation, The Medical School of Qingdao University, Qingdao 266071, Shandong, China
  • Received:2010-09-13 Revised:1900-01-01 Published:2010-12-25 Online:2010-12-25

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被引次数

24

摘要： 目的探讨脑瘫患儿吞咽障碍的特点及其与粗大运动功能分级的关系。方法对2009年6月～2010年6月在本院脑瘫康复中心门诊及住院治疗的脑瘫患儿进行吞咽障碍调查、口运动评估和粗大运动功能评估，分析不同粗大运动功能分级的脑瘫患儿的吞咽问题。结果105例脑瘫患儿中，58例(56.2%)存在吞咽障碍，其中21.9%为轻度吞咽困难，34.3%为中重度吞咽困难。不同粗大运动功能分级 (Gross Motor Function Classification System, GMFCS)的吞咽障碍调查(Dysphagia Disorders Survey, DDS)及口运动评分不同(P<0.001)。DDS和口运动评分与GMFCS水平的相关系数分别为0.767和-0.504(P<0.01)。不同GMFCS分级的吞咽障碍和口运动障碍不同(P<0.001)，DSS分级、口运动障碍和GMFCS分级呈正相关关系(r=0.55, r=0.27)。结论脑瘫患儿吞咽障碍主要发生在口腔期，GMFCS水平越高，吞咽障碍和口运动障碍的比例越高，程度越重，GMFCS水平Ⅳ～Ⅴ级者吞咽障碍和口运动障碍更突出。

关键词: 脑性瘫痪, 吞咽障碍, 口运动障碍, 粗大运动功能分级, 评定

Abstract: ObjectiveTo analyze the characteristics of dysphagia in children with cerebral palsy and explore the relation with the gross motor function classification.MethodsThe children with cerebral palsy in our rehabilitation center from June 2009 to June 2010 were assessed by Dysphagia Disorders Survey(DDS), Oral Motor Assessment and Gross Motor Function Classification System (GMFCS) to explore the relationship between the dysphagia disorders and different gross motor levels.ResultsOf all 105 children with cerebral palsy, 21.9% were mild dysphagia, and 34.3% were moderate to severe dysphagia, resulting in a prevalence of dysphagia of 56.2%. DDS and oral motor scores were changed by GMFCS levels. The correlation coefficient were 0.767 and -0.504 between DDS, oral motor scores and GMFCS, 0.55 and 0.27 between dysphagia, oral motor disorder and the gross motor functions, respectively(P<0.01).ConclusionDysphagia was positively related to severity of motor impairment. Children in GMFCS levels Ⅳ～Ⅴ almost with problems in the pharyngeal and esophageal phases, apparently on the DDS, should be referred for appropriate clinical evaluation of swallowing function.

Key words: cerebral palsy, dysphagia, oral motor disorder, Gross Motor Function Classification System (GMFCS), assessment