[An investigation of medical circumstances of the long-term hospitalized severely mentally and physically handicapped children in Sapporo district].

The author investigated medical circumstances of the severely mentally and physically handicapped children who needed to be treated for more than one month at general hospitals in Sapporo district using a questionnaire method followed by a direct observation. Fifty patients were identified and their chronological ages distributed from 5 months to 19 years old. The mean period of hospitalization was approximately 2 years. They could be roughly divided into two groups; high risk infants for severely mental and physical handicap; and the most severely mentally and physically handicapped teens needing hospital treatment for their lives. Etiology was congenital in 38% (CNS malformations, neuromuscular diseases, etc.), acquired in 36% (hypoxic brain damage due to accidents, CNS infections, etc.) and perinatal in 26% (all hypoxic ischemic encephalopathies). More than 90% of the patients showed abnormal brain CT scan and 20% had visual and/or auditory disturbances. A half of them needed artificial ventilation supports and/or tracheal cannulation. More than 60% received tube feeding therapies. From this evidence, it is considered that the long term hospitalized severely mentally and physically handicapped children have severe brain dysfunction which needs high medical technology and professionals. It seems that a little remedial supports to them is done in general hospitals at present in Sapporo district. Comprehensive treatment will hopefully be done for them in the near future.