脑性瘫痪患儿口运动与构音障碍特征及其临床评定

Characteristics and Evaluation of Oral Dyskinesia and Dysarthria in Children with Cerebral Palsy

目的观察复杂口运动评分(COMS)和口腔轮替速率(DR)对脑瘫患儿口运动和构音障碍的评估结果。方法对107例脑瘫患儿根据汉语版构音障碍检查、简单口运动评分(SOMS)、COMS和DR进行评定,分析SOMS、COMS评分与DR的相关性。结果 85例存在SOMS异常(79.4%),94例存在COMS异常(87.9%)。所有的痉挛型四肢瘫、不随意运动型、共济失调型和混合型脑瘫患儿均存在口运动障碍;痉挛型双瘫与偏瘫患儿口运动障碍发生率较低而且程度较轻。DR最差脑瘫类型依次是痉挛型四肢瘫、不随意运动型、混合型,较好的是共济失调型和痉挛型双瘫,最好的是痉挛型偏瘫。SOMS、COMS与DR评分、最长发音的相关系数均>0.8(P<0.01)。结论脑瘫患儿口运动障碍及构音障碍的发生率和严重程度与脑瘫类型有关。SOMS、COMS与DR、最长发音评估相关性良好。

Objective To observe the efficacy of Complex Oral Motor Scoring（COMS） and diadochokinetic rate（DR） on evaluation of oral motor dysfunction and speech disorders in children with cerebral palsy. Methods 107 children with cerebral palsy were tested with Chinese- version Articulation Test, Simple Oral Motor Scoring（SOMS）, COMS and DR. The correlation among SOMS, COMS and DR was analysesd. Results 85 children were abnormal in SOMS and 94 in COMS. Oral dyskinesia was found in all the children with spastic quadriplegia, dyskinetic, ataxia and mixed type of cerebral palsy, and less in the type of spastic diplegia and hemiplegia. DR was the least in spastic quadriplegia, dyskinetic, mixed type of cerebral palsy, more in the type of ataxia and spastic diplegia, and the most in hemiplegia. The coefficient of correlation among the SOMS, COMS, the longest pronunciation and DR were more than 0.8（P〈0.01）. Conclusion The incidence and severity of oral dyskinesia and dysarthria are associated with the types of cerebral palsy. There is good correlation among SOMS,COMS, longest pronunciation and DR.