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新加坡脑瘫患者的病因、功能结局和医疗保健利用情况。

Causes, functional outcomes and healthcare utilisation of people with cerebral palsy in Singapore.

机构信息

Department of Paediatrics, KK Women's and Children's Hospital, Singapore.

出版信息

Ann Acad Med Singap. 2021 Feb;50(2):111-118. doi: 10.47102/annals-acadmedsg.2020489.

Abstract

INTRODUCTION

A voluntary cerebral palsy (CP) registry was established in 2017 to describe the clinical characteristics and functional outcomes of CP in Singapore.

METHODS

People with CP born after 1994 were recruited through KK Women's and Children's Hospital, National University Hospital and Cerebral Palsy Alliance Singapore. Patient-reported basic demographics, service utilisation and quality of life measures were collected with standardised questionnaires. Clinical information was obtained through hospital medical records.

RESULTS

Between 1 September 2017 and 31 March 2020, 151 participants were recruited. A majority (n=135, 89%) acquired CP in the pre/perinatal period, where prematurity (n=102, 76%) and the need for emergency caesarean section (n=68, 50%) were leading risk factors. Sixteen (11%) of the total participants had post-neonatally acquired CP. For predominant CP motor types, 109 (72%) had a spastic motor type; 32% with spastic mono/hemiplegia, 41% diplegia, 6% triplegia and 21% quadriplegia. The remaining (42, 27.8%) had dyskinetic CP. Sixty-eight (45.0%) participants suffered significant functional impairment (Gross Motor Functional Classification System levels IV-V). Most participants (n=102, 67.5%) required frequent medical follow-up (≥4 times a year).

CONCLUSION

Optimisation of pre- and perinatal care to prevent and manage prematurity could reduce the burden of CP and their overall healthcare utilisation.

摘要

简介

2017 年建立了一个自愿性脑瘫(CP)登记处,以描述新加坡 CP 的临床特征和功能结局。

方法

通过 KK 妇女儿童医院、国立大学医院和新加坡脑瘫联盟招募了 1994 年后出生的 CP 患者。使用标准化问卷收集患者报告的基本人口统计学、服务利用和生活质量措施。通过医院病历获取临床信息。

结果

2017 年 9 月 1 日至 2020 年 3 月 31 日,共招募了 151 名参与者。大多数(n=135,89%)在围产期获得 CP,其中早产(n=102,76%)和紧急剖宫产(n=68,50%)是主要危险因素。16 名(11%)总参与者患有新生儿后获得性 CP。对于主要 CP 运动类型,109 名(72%)为痉挛型运动类型;32%为痉挛性单肢/偏瘫,41%为四肢瘫,6%为三肢瘫,21%为四肢瘫。其余(42,27.8%)为运动障碍型 CP。68 名(45.0%)参与者有严重的功能障碍(粗大运动功能分类系统 4-5 级)。大多数参与者(n=102,67.5%)需要频繁的医疗随访(≥每年 4 次)。

结论

优化围产期保健以预防和管理早产可以减轻 CP 的负担及其整体医疗保健利用。

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