Cadwgan Jill, Goodwin Jane, Fairhurst Charlie
Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust (Kings Health Partners), London, UK.
Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK.
Arch Dis Child Educ Pract Ed. 2019 Apr;104(2):66-73. doi: 10.1136/archdischild-2017-313793. Epub 2018 Jun 15.
While there remains limited intervention to address the damage to the developing brain, current multidisciplinary management of cerebral palsy (CP) needs to minimise the impact of secondary musculoskeletal complications. A focus on comorbidities to maximise function for activity and participation by supporting the child and family in their environment is required. Comprehensive clinical guidance was published by National Institute for Health and Care Excellence (NICE) earlier this year. This article aims to provide a practical clinical approach to the child and family based on:(1) art: empathy, listening and weighing up the clinical picture of the child and family in context; diagnosis, the need for support and space; and care coordination at the right time; and (2) science: the current science in CP care is rapidly expanding in terms of plasticity, pathophysiology, functional assessments and treatments.
虽然针对发育中大脑损伤的干预措施仍然有限，但目前脑瘫（CP）的多学科管理需要尽量减少继发性肌肉骨骼并发症的影响。需要关注合并症，通过在其环境中支持儿童及其家庭，以最大限度地提高活动和参与功能。英国国家卫生与临床优化研究所（NICE）今年早些时候发布了全面的临床指南。本文旨在基于以下方面为儿童及其家庭提供一种实用的临床方法：（1）艺术：同理心、倾听并权衡儿童及其家庭的临床情况；诊断、支持需求和空间；以及适时的护理协调；（2）科学：目前CP护理方面的科学在可塑性、病理生理学、功能评估和治疗方面正在迅速扩展。
