癫患儿社交能力调查及相关因素分析

Study for social skills in children with epilepsy and related factors

目的利用社交反应量表（social responsiveness scale,SRS）对门诊癫癎患儿社交沟通能力的筛查评估,并对筛查评估结果进行相关因素的初步研究。方法选取2013年9月至2014年3月对在复旦大学附属儿科医院癫癎门诊就诊的4-18岁癫癎患儿及6-12岁正常在校儿童进行一项病例对照研究。由其父母填写SRS量表,收集癫癎患儿病史及临床资料,并对癫癎患儿和正常在校儿童的筛查结果、社交反应特点及相关因素进行比较分析。结果癫癎组SRS总分及5个维度得分均高于对照组（χ^2=11.92,P〈0.05）。癫癎组内SRS筛查阳性患儿在SRS5个维度得分均明显高于癫癎组内SRS筛查阴性患儿（P〈0.000 1）。癫癎组各临床特点中,早发癫癎（癫癎首发年龄≤2岁,χ^2=5.26,P=0.02）和智力低下（χ^2=30.04,P〈0.000 1）与SRS筛查阳性相关。结论与正常儿童相比,癫癎患儿存在社交沟通缺陷,提示临床应对癫癎患儿进行常规的社交沟通能力评估,以加强对小儿癫癎的综合管理。

Objective Social responsiveness scale（SRS）was used to evaluate social skills in outpatients with epilepsy,and to analyze the related factors. Methods A case control study was conducted from Sep.,2013 to Mar.,2014.Epileptic patients between 4 and 18 years from epilepsy center in Children′s Hospital,Fudan University and primary students between 6 and 12 years as the control group were enrolled.SRS questionnaires were completed by parents,and clinical history would be collected to do analysis between epileptic patients and primary students,in order to identify the higher risk factors of social difficulties. Results The total score and 5 subscales′score of SRS in epileptic patients were significantly higher than than in the control group（χ^2=11.92,P0.05）.Epileptic patients who had positive results in SRS had significantly higher mean score in 5 subscales than the negative ones（P0.000 1）.In clinical characteristics of epilepsy,early onset epilepsy（age of seizureonset≤2 years,χ^2=5.26,P=0.02）and intellectual disability（ID,χ^2=30.04,P0.000 1）were associated with SRS positive results. Conclusions Children with epilepsy were more likely to have social difficulties compared with general child population.Routine evaluation for social skills should be performed in children with epilepsy,in order to strengthen the management of pediatric epilepsy.