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越南一项基于医院的横断面研究:脑瘫患儿的相关残障情况。

Associated impairments among children with cerebral palsy: findings from a cross-sectional hospital-based study in Vietnam.

机构信息

Faculty of Medical Technology, Phenikaa University, Hanoi, Vietnam.

School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, Queensland, Australia.

出版信息

BMJ Open. 2024 Oct 26;14(10):e075820. doi: 10.1136/bmjopen-2023-075820.

Abstract

OBJECTIVE

This study aims to explore the associated impairments of cerebral palsy (CP) and their correlates among children with CP in Vietnam.

DESIGN

Descriptive cross-sectional study using hospital-based surveillance.

SETTING

National Children's Hospital, Hanoi, Vietnam between June and November 2017.

PARTICIPANTS

765 children with CP were recruited.

OUTCOME MEASURES

We assessed clinical characteristics of CP, associated impairments (epilepsy, intellectual, visual, hearing, speech impairments) and their correlates. We performed descriptive analyses (median, IQR and proportion). χ test and Fisher's exact test were used for categorical variables. Univariate logistic regression and multivariate logistic regression models were established and associated impairments were included as independent variables.

RESULTS

The median age of children was 1.7 years (IQR=2.7). Quadriplegia was the predominant subtype (69.5%) and 46.5% were at Gross Motor Function Classification System level IV-V. Of children, 76.3% had ≥one associated impairment, most commonly speech or intellectual impairments (59.1% and 57.8%, respectively). Severity of motor impairment, type of CP, maternal and perinatal factors (eg, gestational age, perinatal asphyxia, timing of injury causing CP) were associated with greater risk of associated impairments.

CONCLUSION

Children with CP have a high burden of associated impairments. Findings from our study will inform the development and implementation of appropriate screening and interventions and reduce the long-term adverse effects of these impairments on individuals with CP and their socioeconomic impact.

摘要

目的

本研究旨在探索越南脑瘫(CP)患儿的相关障碍及其相关性。

设计

使用基于医院监测的描述性横断面研究。

地点

越南河内国家儿童医院,2017 年 6 月至 11 月。

参与者

招募了 765 名脑瘫患儿。

结局指标

评估 CP 的临床特征、相关障碍(癫痫、智力、视力、听力、言语障碍)及其相关性。我们进行了描述性分析(中位数、IQR 和比例)。χ²检验和 Fisher 确切检验用于分类变量。建立了单变量逻辑回归和多变量逻辑回归模型,并将相关障碍作为自变量。

结果

儿童的中位年龄为 1.7 岁(IQR=2.7)。四肢瘫是最主要的亚型(69.5%),46.5%处于粗大运动功能分级系统(GMFCS)Ⅳ-Ⅴ级。76.3%的患儿存在≥1 种相关障碍,最常见的是言语或智力障碍(分别为 59.1%和 57.8%)。运动障碍严重程度、CP 类型、母婴及围产期因素(如胎龄、围产期窒息、导致 CP 的损伤时机)与相关障碍的发生风险增加相关。

结论

脑瘫患儿存在较高的相关障碍负担。本研究结果将为制定和实施适当的筛查和干预措施提供信息,并减轻这些障碍对脑瘫患儿及其社会经济的长期不良影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ca28/11535665/c9901ccd5845/bmjopen-14-10-g001.jpg

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