邱晒红,彭婷婷,杨雯,等.重度脑瘫患儿的营养状况、社会生活能力及进食与饮水能力的特征及其相关性分析[J].中华物理医学与康复杂志,2025,47(11):1005-1010
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| 重度脑瘫患儿的营养状况、社会生活能力及进食与饮水能力的特征及其相关性分析 |
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| DOI：10.3760/cma.j.cn421666-20240410-00253 |
| 中文关键词: 脑性瘫痪 功能障碍 营养 社会生活能力 进食能力 |
| 英文关键词: Cerebral palsy Nutrition Social life ability Eating and drinking ability |
| 基金项目:广州市医疗高地临床特色技术项目（2023C-TS59）；广州市科技计划项目（2024A03J01274） |
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| 中文摘要: |
| 目的 分析重度脑瘫患儿营养状况、社会生活能力及进食与饮水能力的特征及其三者的相关性。 方法 募集粗大运动功能分级系统为IV～V级的脑瘫患儿334例进行社会生活能力、进食与饮水能力分级系统（EDACS或miniEDACS分级）和营养状况评估，并采用Logistic回归分析患儿营养状况、社会生活能力和进食与饮水能力的影响因素。 结果 334例重度脑瘫患儿中，营养缺乏的发生率为71.5%，超重或肥胖的发生率为4.5%。334例重度脑瘫患儿中，80.5%的患儿社会生活能力处于轻度低下～极重度低下，15.0%的患儿社会生活能力处于边缘水平；57.5%的患儿存在轻中度进食与饮水功能障碍，13.5%的患儿有重度进食与饮水功能障碍。男孩发生营养缺乏和过剩的风险比女孩更高（OR=2.41，P＜0.05）；随着年龄的增长，患儿的进食与饮水能力等级可能下降（OR=2.41，P＜0.05），而其社会生活能力的标准分则会提高（OR=1.21，P＜0.05）；营养缺乏和过剩的脑瘫患儿，其社会生活能力落后的风险显著高于营养正常的脑瘫患儿（OR=1.38，P＜0.05）；患儿的社会生活能力标准分越高，其出现重度进食与饮水障碍的风险越低（OR=0.45，P＜0.05）。 结论 营养缺乏和过剩、社会生活能力和进食与饮水能力受损在重度脑瘫患儿中普遍存在，且三者相互关联。男孩发生营养缺乏和过剩的风险显著高于女孩，而随着年龄的增长，患儿的进食与饮水能力呈改善趋势。 |
| 英文摘要: |
| Objective To observe any relationships among the nutritional status, the social abilities, and the eating and drinking ability of children with severe cerebral palsy. Methods A total of 334 children with cerebral palsy, classified as level IV or V according to the gross motor function classification system, were enrolled. Their social ability, and their eating and drinking performance were assessed using the eating and drinking ability classification system (EDACS) or the mini-EDACS classification, and their nutritional status was also evaluated. Logistic regressions were evaluated seeking any useful inter-relationships. Results The incidence of nutritional deficiency among the children was estimated at 71.5%, with 4.5% overweight or obese. 80.5% of the children exhibited mild to profound impairment in their social abilities, with another 15.0% on the borderline. The eating and drinking ability of 57.5% was rated as mildly to moderately dysfunction, with another 13.5% of severe dysfunction. The boys had a higher rate of nutritional deficiency and excess compared to the girls (OR=2.41, P≤0.05). And eating and drinking ability was observed to improve with age (OR=2.41, P≤0.05), while the average standard score for social ability improved (OR=1.21, P≤0.05). Those nutritionally deficient or in excess had a significantly higher rate of impaired social ability compared to healthy children (OR=1.38, P≤0.05). A higher standard score for social living ability was associated with a lower risk of severe eating and drinking dysfunction (OR=0.45, P≤0.05). Conclusions Malnutrition, impaired social ability, and impaired eating and drinking ability are common in children with severe cerebral palsy, and these three factors are inter-related. Boys have a significantly higher rate of nutritional deficiency or excess compared to girls. However, eating and drinking ability improves with age. |
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