Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK.
Acta Paediatr. 2010 Mar;99(3):446-51. doi: 10.1111/j.1651-2227.2009.01626.x. Epub 2009 Dec 10.
To determine the prevalence and associations of self-reported and parent-reported pain in children with cerebral palsy (CP) of all severities.
Cross-sectional design using a questionnaire; analysis using ordinal regression. Children aged 8-12 years were randomly selected from population-based registers of children with CP in eight European regions; a further region recruited 75 children from multiple sources. Outcome measures were pain in the previous week among children who could self-report and parents' perception of their child's pain in the previous 4 weeks.
Data on pain were available from 490 children who could self-report and parents of 806 children (those who could and could not self-report). The estimated population prevalence of self-reported pain in the previous week was 60% (95% CI: 54-65%) and that of parent-reported pain in the previous 4 weeks was 73% (95% CI: 69-76%). In self-reporting children, older children reported more pain but pain was not significantly associated with severity of impairment. In parent reports, severity of child impairment, seizures and parental unemployment were associated with more frequent and severe pain.
Pain in children with CP is common. Clinicians should enquire about pain and consider appropriate physical, therapeutic or psychological management.
确定所有严重程度脑瘫(CP)患儿自我报告和家长报告的疼痛的患病率和相关性。
使用问卷进行横断面设计;使用有序回归进行分析。从 8 个欧洲地区基于人群的 CP 患儿登记处随机选择 8-12 岁的儿童;另一个地区从多个来源招募了 75 名儿童。结局测量指标为能够自我报告的儿童在过去一周内的疼痛情况,以及父母在过去 4 周内对其子女疼痛的感知情况。
可获得 490 名能够自我报告的儿童和 806 名儿童的父母(能够和不能自我报告的儿童)的疼痛数据。估计在过去一周内自我报告的疼痛的人群患病率为 60%(95%CI:54-65%),在过去 4 周内父母报告的疼痛患病率为 73%(95%CI:69-76%)。在自我报告的儿童中,年龄较大的儿童报告的疼痛更多,但疼痛与残疾严重程度无显著相关性。在父母报告中,儿童残疾的严重程度、癫痫发作和父母失业与更频繁和更严重的疼痛有关。
脑瘫儿童的疼痛很常见。临床医生应询问疼痛情况,并考虑适当的身体、治疗或心理管理。