血液肿瘤患儿躯体功能状态评估的初步研究

A pilot assessment study of physical functioning in children with hematological cancers

目的对血液肿瘤患儿的躯体功能状态进行评估,为康复治疗提供依据。方法通过人体测量(身高、体重、腰围等)、日常生活活动能力(ADL)评定、运动技能测试(3 m步行时间测试)和生活方式问卷调查,对15例(男11例,女4例,中位年龄4.75岁,年龄范围1岁8个月~8岁10个月)已获得完全缓解(CR)的血液肿瘤患儿进行躯体功能状态评估。结果对照正常儿童发现,处于诱导治疗期的5例患儿,测量其皮脂厚度为7.5~8.5 mm,处于其年龄正常范围。处于维持治疗期的10例患儿中,腰围≥第80百分位(P80)比例较大(首次和再次评估均有7人腰围≥P80,均占70%);ADL较差,其中6例患儿未达到与其年龄相适应的ADL。自身对照发现,维持治疗期患儿住院期间接触电子产品时间多,为居家时的2.15倍(t=7.746,P<0.001);对比评估期间3m步行时间测试结果差异无显著性(t=-0.358,P=0.728)。结论维持治疗期血液肿瘤患儿躯干脂肪堆积,ADL下降,住院期间下床活动时间少,评估期间粗大运动能力无显著改变。上述因素可能对治疗期间及病后生存质量产生不良影响,需进一步开展血液肿瘤患儿躯体功能状态评估,以探索有效的干预措施。

Objective To evaluate the physical fitness of children with hematological cancers.Methods Fiften children （11 boys,4 girls;median age：4.75 years;age range：1.7 ～ 8.9 years） who were treating for hematological cancers according to the Tongji-95 protocol were studied.Anthropometric measures,motor skills,activities of daily living （ADL） and questionnaires comprised the main part of the evaluation.Results The range of skin fold in induce group was 7.5 ～ 8.5 mm.Seven of ten patients show that waist circumference increased significantly.Six in ten was scored lower than normal in ADL （WeeFIM）.Inactivity time,especially,screen time in wards was more than double in their home （t =7.746,P 〈0.001）.There were no significantly change 3m walk test during the period of evaluation（t =-0.358,P=0.728）.Conclusions The study revealed that motor performance was decreased during chemotherapy among the children with hematological cancers.Low physical fitness lead to poor quality of life,therefore regular physical activity has potential benefits for pediatric hematological cancer.