数码听觉统合训练对痉挛型脑瘫患儿智力及语言障碍的影响

Effect of digital auditory integration training on intellectual disability and language disorder of children with spastic cerebral palsy

目的：探讨数码听觉统合训练对痉挛型脑瘫患儿智力及语言的治疗效果和脑功能恢复情况。方法：选取2011年1月-2013年12月在该科门诊随访且已停止常规康复治疗的痉挛型脑瘫患儿60例,随机分为治疗组（30例）和对照组（30例）。治疗组接受数码听觉统合训练治疗,对照组不采取任何治疗措施,采用盖什尔（Gesell）发育量表评定治疗前后患儿智力及语言方面的变化情况,并用SPECT观察两组患儿治疗前后脑血流灌注情况。结果：治疗组患儿社会适应能力、个人社交能力及语言能力发育商（DQ）总体均数高于治疗前,差异有统计学意义（P〈0.05）;经治疗前后头颅SPECT检查比较,对照组和治疗组治疗前脑血流异常灌注率均为100.00%,多位于额颞脑叶。治疗组经数码听觉统合训练治疗后,脑血流异常灌注率下降到36.67%,对照组无明显变化。结论：数码听觉统合训练能促进痉挛型脑瘫患儿智力及语言等认知方面的发育水平;改善患儿大脑血液的异常灌注,是治疗脑瘫的一项重要辅助方法。

Objective： To explore the curative effect of digital auditory integration training for intellectual disabihty and language disorder among children with spastic cerebral palsy and brain function recovery. Methods： Sixty children with spastic cerebral palsy followed up in outpatient department of the hospital were selected from January 2011 to December 2013, conventional rehabilitation therapy was stopped among them, all the children were randomly divided into treatment group and control group, 30 children in each group. The children in treatment group were treated with digital auditory integration training, while the children in control group did not receive any treatment. Gesell development schedule was used to evaluate intellectual and language changes of the children before and after treatment; SPECT was used to observe cerebral blood flow perfusion changes before and after treatment. Results： In treatment group, social adaptive capacity score, personal-social capacity score, and development quotient （DQ） of language competence after treatment were statistically significantly higher than those before treatment （P〈0. 05 ）; before treatment, the rates of abnormal cerebral blood flow perfusion in control group and treatment group were 100. 00%, locating in frontal lobe and temporal lobe. After digital auditory integration training, the rate of abnormal cerebral blood flow perfusion in treatment group decreased to 36. 67%, there was no obvious change in control group. Conclusion： Digital auditory integration training can promote intelligence and language development levels and improve abnormal cerebral blood flow perfusion of children with spastic cerebral palsy, which is an important auxiliary method in treatment of spastic cerebral palsy.