枣庄市农村1-6岁儿童脑瘫现况分析

发布时间：2019-05-27 12:06

【摘要】：脑性瘫痪简称脑瘫（CP），是指自受孕开始至婴儿期非进行性脑损伤和发育缺陷所致的综合征，主要表现为运动障碍及姿势异常，是小儿时期最常见的一种伤残疾患。世界卫生组织报道儿童脑瘫患病率在1‰ 5‰之间。国内目前缺乏对于全国性脑瘫儿童患病率的报道。2001年我国六省（自治区）1-6岁小儿进行抽样调查,平均患病率为1.92‰。脑瘫的危险因素很多，病因存在多样性和复杂性。140多年前Little描述脑瘫时提出异常分娩、难产、新生儿窒息等引起缺氧是导致脑瘫发病的主要病因，这一结果在很长一段时间得到广泛认可。既往认为,产时因素占第1位，近年来随着研究的深入和发展,目前认为产前因素为主要原因。目的：通过描述枣庄市农村1-6岁儿童脑瘫患病情况，分析枣庄市农村儿童脑瘫危险因素，为儿童脑瘫防治工作提供参考，促进儿童脑瘫康复工作。方法：采用随机整群抽样调查方法，对调查地区全部满足条件的1-6岁儿童进行流行病学调查。以确诊的脑瘫患儿作为病例组，按1:4比例对确诊的脑瘫儿童匹配4名正常儿童构成病例对照，进行儿童脑瘫危险因素分析。应用Epidata3.1统计软件建立数据库，运用SPSS13.0统计软件进行统计学处理。结果： 1．共登记1-6岁儿童20077人，确诊脑瘫儿童36人，患病率为1.79‰。以5-6岁（不含6岁）年龄组患病率最高，为2.07‰。男性患儿24人，女性患儿12人，男性患病率略高于女性。 2．36例患儿在发现异常后，97.2%选择在当地医院诊治，94.4%在妇幼保健院进行诊治；72.2%病例选择多种方式结合的康复方式；94.4%的当地医院无法制作矫形器及辅助工具；61.1%的脑瘫患儿进行登记，但进行随访的仅占17.1%；2.8%患儿建立监测档案；97.2%患儿的治疗费用可以得到部分报销；47.2%患儿可以得到政府给予的专项经济资助。 3．36例脑瘫儿童中，，痉挛型24例,占66.7%,；其次为肌张力低下型6例,占16.7%；共济失调型3例，占8.3%；不随意运动型2例，占5.6%；强直1例，占2.8%。 4.经单因素分析发现具有统计学意义的因素分别为父亲年龄（＞30岁）（OR=3.125）、家庭人均年收入（≤1万）（OR=2.802）、精神疾患家族史（OR=12.000）、母亲孕期患感冒（OR=11.989）、孕妇被动吸烟次数(≥2次)（OR=8.413）、孕次（≥2次）（OR=4.206）、流产次数(≥1次)（OR=6.122）、早产史（OR=7.358）、产程延长(＞24h)（OR=12.000）。36例脑瘫儿童中新生儿窒息为9例，占总病例数的25%，对照组无窒息病例。经多因素条件Logistic逐步回归分析结果共有4个因素进入方程，分别是母孕期感冒（OR=13.737）、孕妇被动吸烟次数(≥2次)（OR=18.308）、流产次数(≥1次)（OR=14.347）和早产史（OR=15.888）。结论： 1.枣庄市农村1-6岁儿童脑瘫患病率1.79‰，接近我国六省区1-6岁儿童脑瘫患病率平均水平，男性患儿居多。 2．枣庄市农村1-6岁脑瘫儿童在发现异常后多数选择到当地妇幼保健院进行诊治，并且大部分采取多种方式结合的康复方式；较多的患儿进行了登记但继续随访的很少；多数患儿治疗费用可以得到部分报销。 3．枣庄市农村1-6岁儿童脑瘫临床类型以痉挛型为主,其它依次为肌张力低下型、共济失调型、不随意运动型、强直型。 4.枣庄市农村1-6岁儿童脑瘫的主要危险因素是：窒息、流产次数（≥1次）、孕妇被动吸烟情况、母孕期感冒和早产史。
[Abstract]:Cerebral palsy (CP) refers to the syndrome caused by non-progressive brain injury and developmental defects from the beginning of conception to infancy. It is mainly characterized by dyskinesia and abnormal posture, which is the most common disability in the childhood. The prevalence of cerebral palsy reported by the World Health Organization is in the range of 1 to 5% 1-6-year-old children in six provinces of China (autonomous regions) in 2001, with an average prevalence of 1.92. The risk factors of cerebral palsy are many, the cause of the causes is variety and complexity. In the last 140 years, Little describes the main causes of cerebral palsy, such as abnormal delivery, dystocia, and neonatal asphyxia. The result is widely recognized for a long time. However, in recent years, with the development of the study, the prenatal factors are considered to be the primary factors. Objective: To study the risk factors of cerebral palsy in the rural children of Zaozhuang City, to provide a reference for the prevention and treatment of cerebral palsy in Zaozhuang City, and to promote the children's cerebral palsy. Complex work. Methods:1-6-year-old children with all conditions in the investigated area were given a random cluster sampling method. The children with cerebral palsy were matched with 4 normal children according to the ratio of 1:4 as the case group, and the children with cerebral palsy were in danger of cerebral palsy. Risk factors analysis. The database is established by using the Epidata3.1 statistical software, and the software is used for statistical software of SPSS13.0. to be in series Results:1.1-6-year-old children were enrolled, and 36 children with cerebral palsy were diagnosed with cerebral palsy. The prevalence was 1.79%, with 5-6 years of age (excluding 6 years of age). The highest rate was 2.07%. There were 24 male children and 12 female children. The prevalence of male was slightly higher than that of female. 2.36 children with abnormal findings, 97.2% chose to diagnose and treat the local hospital, 94.4% had the diagnosis and treatment in the mother and child health care hospital, 72.2% of the cases chose a variety of ways to combine the rehabilitation mode, 94.4% of the local hospitals were unable to make the orthoses and auxiliary tools,6. 1.1% of the children with cerebral palsy were registered, but only 17.1% of the follow-up, 2.8% of the children established the monitoring file, the treatment cost of 97.2% of the children can be partially reimbursed, and 47.2% of the patients can The special economic support given by the government was obtained. In 3.36 children with cerebral palsy,24 cases of spastic type, 66.7%,6 cases of hypotonicity, 16.7%,3 cases of ataxia type, 8.3%, and 2 cases of non-casual sports. The results of single factor analysis showed that the factors of statistical significance were the father's age (> 30 years) (OR = 3.125), the family per capita annual income (OR = 2.802), family history of mental illness (OR = 12.000), and mother's family history (OR = 12.000). The number of passive smoking in the pregnant women (OR = 11.989), the number of passive smoking in the pregnant women (OR = 8.413), the number of pregnancies (OR = 4.206), the number of abortions (OR = 6.122), the history of premature labor (OR = 7.358), the extension of labor (> 24 hours) (OR = 12.000). The asphyxiation was 9 cases, accounting for 9 cases. The total number of cases was 25%, and the control group was not suffocation. The results of the multiple-factor conditional logistic regression analysis showed that 4 factors entered the equation, which were female's common cold (OR = 13.737), the number of passive smoking in the pregnant women (OR = 18.308), and the number of abortions (OR = 14.34). 7) and The history of premature birth (OR = 15.888). Conclusion:1. The prevalence of cerebral palsy in the rural area of Zaozhuang is 1.79%, which is close to the six provinces in China. -The prevalence of cerebral palsy in the 6-year-old was the average, with the most of the male.2. The children of 1-6 years of age in the rural area of Zaozhuang were selected to the local maternal and child health care hospital for diagnosis and treatment, and most of them were combined in a variety of ways. The way of rehabilitation; more children have been registered, but further 3. The clinical types of children with cerebral palsy from 1 to 6 years of age in the rural area of Zaozhuang are mainly of the type of spasm, and the other cases The main risk factors of children's cerebral palsy in the rural areas of Zaozhuang are: the suffocation, the flow
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R742.3

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