脑瘫患儿的社会生活能力评定研究

The study of assessment of social life ability for children with cerebral palsy

目的了解脑瘫患儿社会生活能力的现状、特征及其与年龄、严重程度的相关性。方法采用粗大运动功能分级系统（GMFCS）评价患儿的严重程度，应用有中国常模的婴儿一初中生社会生活能力量表对79例1～14岁不伴智力低下的脑瘫患儿和79例正常对照组儿童的家长进行调查，分析不同年龄、瘫痪类型和严重程度的患儿的社会生活能力状况，并与正常对照组进行比较。结果在交往、自我管理方面，惠儿与正常儿童比较，差异无统计学意义（P〉0．05）。但在独立生活、运动、作业、参加集体活动能力及总的社会生活能力得分方面，与正常儿童相比，各年龄段的差异均有统计学意义（P〈0．05）；不同瘫痪类型与正常儿童之间比较，差异有统计学意义（P〈0．05），进一步两两比较结果显示，偏瘫患儿高于双瘫，双瘫高于四肢瘫；各项分值GMFCS组别间比较，组间差异均有统计学意义（P〈0．05），进一步两两比较结果显示，正常组、GMFCSI级、Ⅱ级、Ⅲ级、Ⅳ／Ⅴ级之间比较差异均有统计学意义（P〈0．05）；患儿的GMFCS分级水平与其标准分呈负相关（ys=-0．517，P=0．000）。结论脑瘫患儿的社会生活能力为活动受限所影响，活动受限程度越高的患儿，其社会生活能力表现越差，但在交往和自我管理方面的能力影响相对较小。

[ Objective ] To study the situation, characteristics and correlation of social life ability for children with cerebral palsy （CP）. [ Methods ] After signing the informed consent, the caregivers of children with CP（n=79） and normal control group（n=79）, aged 1 to 14 years, were assessed with the social life ability scale for infant-junior middle school student. According to ages, types of paralysis, level of gross motor function classification system （GMFCS） of children with CP, the situation, characteristics and correlation of social life ability in children with CP was performed, and compared with their performance between children with CP and the control group. [ Resluts ] Children with CP had good ability in communication and self-direction domains And no significant difference was found between children with CP and normal children （P〉0.05）, however, there were differences in Self-Help, locomotion, occupation, Socialization. Compared with the same aged normal children, the gap with different types of cerebral palsy was more obvious （P〈0.05）. Significant difference was found among GMFCS groups and normal children（P〈0.05）. The standard scores were negatively correlated with GMFCS level （ys=-0.517, P=O.O00）. [ Conclusion ] The social life ability for children with CP was associated strongly with activity limitation. The more activity limitation, the poorer social life ability. Whereas they might have good ability in communication and self-direction domains.