婴儿痉挛症患儿智能结构变化对综合康复训练效果的判断价值

Effects of intelligence structure changes on comprehensive rehabilitation efficiency in children with infantile spasms

目的探讨婴儿痉挛症(IS)患儿智能结构变化对综合康复训练效果的判断价值,为指导临床康复治疗、判断IS患儿预后提供理论依据。方法 2009年2月至2013年2月收治的27例IS患儿,依据监护人是否同意进行康复训练分为康复训练组(康复组)和拒绝行康复训练组(对照组),其中康复组19例,对照组8例;两组患儿均给予抗癫痫药物控制痉挛发作,康复组患儿再根据病情给予康复训练,记录治疗3月前后粗大运动、精细动作、言语能、适应性、社交行为5项指标发育月龄(DA)的差值和发育商(DQ)及其差值。应用SPSS 17.0软件进行数据处理,康复治疗前后发育商值的对比采用自身配对t检验,发育商值的组间两两比较采用两独立样本t检验。结果两组患儿治疗后的DQ值[康复组:(59.40±7.85)分,对照组:(52.88±9.50)分]均明显低于治疗前[(康复组:(67.32±7.61)分,t=6.861,P<0.05;对照组:(67.86±8.39)分,t=8.875,P<0.05],康复组患儿的适应性[(0.89±0.52)分]和社交行为[(0.79±0.54)分]较对照组[适应性:(0.50±0.38)分,t=1.946,P>0.05;社交行为:(0.56±0.42)分,t=1.066,P>0.05]有所好转,但差异无统计学意义,精细动作[(1.34±0.62)分]评分高于对照组[(0.81±0.53)分,t=2.095,P<0.05],差异有统计学意义,粗大运动[(1.42±0.56)分]、言语能[(1.32±0.48)分]和DQ差[(-7.92±5.03)分]较对照组[粗大运动:(0.75±0.38)分,t=3.091,P<0.05;言语能:(0.69±0.59)分,t=2.907,P<0.05;DQ差:(-14.99±4.78)分,t=3.379,P<0.05]差异有统计学意义。结论 IS患儿智能结构变化能反映综合康复训练的临床效果,综合康复训练可改善IS患儿精神发育迟滞症状,尤其是粗大运动、精细动作和言语能方面。

Objective To analyze the effect of intelligence structure changes on comprehensive rehabilitation efficiency in children with infantile spasms(IS).This study may be benefit for guiding the clinical therapy and provide the theoretical basis for IS children prognosis.Methods Twenty-seven children with IS diagnosed in hospital from February 2009 to February 201 3 were divided into the rehabilitation group (ninteen cases)and the control group(eight cases).All cases were treated with the anti-epilepsy drugs (AEDs)to control spasms.The rehabilitation group was combined with rehabilitation therapies.Three months after treatmeat,the neuropsychological development scales were used to test the score and distance of gross motor,exiguous,language,adaptive area,social intercourse and the development quotient (DQ ).The difference of DQ points was compared with t-test.Results The DQ points of the two groups of patients(the rehabilitation group:59.40 ±7.85,the control group:52.88 ±9.50)were significantly lower than those before(the rehabilitation group:67.32 ±7.61 ,t =6.861 ,P <0.05;the control group:67.86 ±8.39,t =8.875,P<0.05).The distances of gross motor(1 .42 ±0.56,0.75 ±0.38,t=3.091 ,P<0.05),fine motor (1 .34 ±0.62,0.81 ±0.53,t =2.095,P <0.05),language(1 .32 ±0.48,0.69 ±0.59,t =2.907,P <0.05)and DQ(-7.92 ±5.03,-1 4.99 ±4.78,t =3.379,P <0.05 )of the rehabilitation group were significantly improved than those of the control group.Although there were some improvements in the distances of adaptive area(0.89 ±0.52,0.5 ±0.38,t =1 .946,P >0.05)and social intercourse(0.79 ± 0.54,0.56 ±0.42,t=1 .066,P>0.05),there was no statistical significance.Conclusions The rehabilitation can improve the mental retardation of IS,especially in the aspects of gross motor,exiguous and language.