School of Rehabilitation, Capital Medical University, Beijing, 100068, China.
School of Rehabilitation, Capital Medical University, Beijing, 100068, China; Department of Spine and Spinal Cord Surgery, Beijing Boai Hospital, China Rehabilitation Research Center, Beijing, 100068, China.
Chin J Traumatol. 2023 Jan;26(1):14-19. doi: 10.1016/j.cjtee.2022.05.001. Epub 2022 May 18.
The long-term situation of children with spinal cord injury (SCI) was investigated, and suggestions for helping them better return to the society were provided.
SCI patients less than 18 years old hospitalized in Beijing Boai Hospital from January 2011 to December 2020 were retrospectively analyzed. Information including motor function, complications, characteristic changes, self-care abilities, school attendance and social participation were collected by telephone interview and electronic questionnaire. All the answers were statistically analyzed.
A total of 86 cases were enrolled, 77 girls and 9 boys, with a median injury age of 6 years and 2 months. The follow-up time was 3-130 months. The main cause of trauma in these children was sport injury (66.3%), the thoracic spinal cord was involved the most (91.9%), and complete SCIs accounted for the majority (76.7%). In terms of complications, children with complete SCIs were more likely to have urinary incontinence, constipation and characteristic changes (p < 0.05); whereas the incomplete SCIs often have spasticity (p < 0.05). As to the daily living abilities, children with incomplete lumbar SCIs were more capable to accomplish personal hygiene, transfer, and bathing independently than those with complete injuries, or cervical/thoracic SCIs, respectively (p < 0.05). Moreover, children older than 9 years care more able to dress and transfer independently than the youngers (p < 0.05). Wheelchair users accounted for 84.9% and more than half of them were able to propel wheelchair independently, and those who move passively in wheelchairs were mostly introverted kids (p < 0.05). Almost all (93.8%) children with incomplete injuries were able to walk independently. Most (79.1%) children continued to attending school, and 41.9% participated in interest classes. Unfortunately, 67.4% of the children spent less time playing with their peers than before the injury.
SCIs impair physical structures and function of children, affect their independence in daily living, and restrict school attendance and social interaction. Comprehensive rehabilitation after injury is a systematic work. Medical staff and caregivers should not only pay attention to neurological function, but also help them improve self-care abilities. It is also important to balance rehabilitation training and school work and social participation.
调查脊髓损伤（SCI）患儿的长期情况，并为帮助他们更好地回归社会提供建议。
回顾性分析 2011 年 1 月至 2020 年 12 月期间在北京博爱医院住院的年龄小于 18 岁的 SCI 患儿。通过电话访谈和电子问卷收集运动功能、并发症、特征变化、自理能力、上学和社会参与等信息。对所有答案进行统计学分析。
共纳入 86 例患儿，其中女孩 77 例，男孩 9 例，中位损伤年龄为 6 岁 2 个月。随访时间为 3-130 个月。这些儿童的主要创伤原因是运动损伤（66.3%），最常累及胸椎脊髓（91.9%），大多数为完全性 SCI（76.7%）。在并发症方面，完全性 SCI 患儿更易发生尿失禁、便秘和特征性变化（p<0.05）；而不完全性 SCI 患儿常有痉挛（p<0.05）。在日常生活能力方面，不完全性腰骶部 SCI 患儿在个人卫生、转移和洗澡方面比完全性损伤或颈胸段 SCI 患儿更有能力独立完成（p<0.05）。此外，9 岁以上的患儿比年龄较小的患儿更能独立穿衣和转移（p<0.05）。轮椅使用者占 84.9%，其中超过一半的人能够独立推动轮椅，而那些被动使用轮椅的人大多性格内向（p<0.05）。几乎所有（93.8%）不完全性损伤患儿都能独立行走。大多数（79.1%）患儿继续上学，其中 41.9%参加兴趣班。遗憾的是，67.4%的患儿比受伤前花更少的时间与同龄人玩耍。
SCI 损害儿童的身体结构和功能，影响其日常生活的独立性，并限制其上学和社会交往。受伤后的综合康复是一项系统工程。医务人员和照顾者不仅要关注神经功能，还要帮助他们提高自理能力。平衡康复训练与学业和社会参与也很重要。
