【摘要】：腦性癱瘓簡稱腦癱（CP），是指自受孕開始至嬰兒期非進行性腦損傷和發(fā)育缺陷所致的綜合征，主要表現(xiàn)為運動障礙及姿勢異常，是小兒時期最常見的一種傷殘疾患。 世界衛(wèi)生組織報道兒童腦癱患病率在1‰ 5‰之間。國內(nèi)目前缺乏對于全國性腦癱兒童患病率的報道。2001年我國六�。ㄗ灾螀^(qū)）1-6歲小兒進行抽樣調(diào)查,平均患病率為1.92‰。腦癱的危險因素很多，病因存在多樣性和復(fù)雜性。140多年前Little描述腦癱時提出異常分娩、難產(chǎn)、新生兒窒息等引起缺氧是導(dǎo)致腦癱發(fā)病的主要病因，這一結(jié)果在很長一段時間得到廣泛認可。既往認為,產(chǎn)時因素占第1位，近年來隨著研究的深入和發(fā)展,目前認為產(chǎn)前因素為主要原因。 目的：通過描述棗莊市農(nóng)村1-6歲兒童腦癱患病情況，分析棗莊市農(nóng)村兒童腦癱危險因素，為兒童腦癱防治工作提供參考，促進兒童腦癱康復(fù)工作。 方法：采用隨機整群抽樣調(diào)查方法，對調(diào)查地區(qū)全部滿足條件的1-6歲兒童進行流行病學調(diào)查。以確診的腦癱患兒作為病例組，按1:4比例對確診的腦癱兒童匹配4名正常兒童構(gòu)成病例對照，進行兒童腦癱危險因素分析。 應(yīng)用Epidata3.1統(tǒng)計軟件建立數(shù)據(jù)庫，運用SPSS13.0統(tǒng)計軟件進行統(tǒng)計學處理。 結(jié)果： 1．共登記1-6歲兒童20077人，確診腦癱兒童36人，患病率為1.79‰。以5-6歲（不含6歲）年齡組患病率最高，為2.07‰。男性患兒24人，女性患兒12人，男性患病率略高于女性。 2．36例患兒在發(fā)現(xiàn)異常后，97.2%選擇在當?shù)蒯t(yī)院診治，94.4%在婦幼保健院進行診治；72.2%病例選擇多種方式結(jié)合的康復(fù)方式；94.4%的當?shù)蒯t(yī)院無法制作矯形器及輔助工具；61.1%的腦癱患兒進行登記，但進行隨訪的僅占17.1%；2.8%患兒建立監(jiān)測檔案；97.2%患兒的治療費用可以得到部分報銷；47.2%患兒可以得到政府給予的專項經(jīng)濟資助。 3．36例腦癱兒童中，，痙攣型24例,占66.7%,；其次為肌張力低下型6例,占16.7%；共濟失調(diào)型3例，占8.3%；不隨意運動型2例，占5.6%；強直1例，占2.8%。 4.經(jīng)單因素分析發(fā)現(xiàn)具有統(tǒng)計學意義的因素分別為父親年齡（＞30歲）（OR=3.125）、家庭人均年收入（≤1萬）（OR=2.802）、精神疾患家族史（OR=12.000）、母親孕期患感冒（OR=11.989）、孕婦被動吸煙次數(shù)(≥2次)（OR=8.413）、孕次（≥2次）（OR=4.206）、流產(chǎn)次數(shù)(≥1次)（OR=6.122）、早產(chǎn)史（OR=7.358）、產(chǎn)程延長(＞24h)（OR=12.000）。36例腦癱兒童中新生兒窒息為9例，占總病例數(shù)的25%，對照組無窒息病例。經(jīng)多因素條件Logistic逐步回歸分析結(jié)果共有4個因素進入方程，分別是母孕期感冒（OR=13.737）、孕婦被動吸煙次數(shù)(≥2次)（OR=18.308）、流產(chǎn)次數(shù)(≥1次)（OR=14.347）和早產(chǎn)史（OR=15.888）。 結(jié)論： 1.棗莊市農(nóng)村1-6歲兒童腦癱患病率1.79‰，接近我國六省區(qū)1-6歲兒童腦癱患病率平均水平，男性患兒居多。 2．棗莊市農(nóng)村1-6歲腦癱兒童在發(fā)現(xiàn)異常后多數(shù)選擇到當?shù)貗D幼保健院進行診治，并且大部分采取多種方式結(jié)合的康復(fù)方式；較多的患兒進行了登記但繼續(xù)隨訪的很少；多數(shù)患兒治療費用可以得到部分報銷。 3．棗莊市農(nóng)村1-6歲兒童腦癱臨床類型以痙攣型為主,其它依次為肌張力低下型、共濟失調(diào)型、不隨意運動型、強直型。 4.棗莊市農(nóng)村1-6歲兒童腦癱的主要危險因素是：窒息、流產(chǎn)次數(shù)（≥1次）、孕婦被動吸煙情況、母孕期感冒和早產(chǎn)史。
[Abstract]:Cerebral palsy (CP) refers to the syndrome caused by non-progressive brain injury and developmental defects from the beginning of conception to infancy. It is mainly characterized by dyskinesia and abnormal posture, which is the most common disability in the childhood. The prevalence of cerebral palsy reported by the World Health Organization is in the range of 1 to 5% 1-6-year-old children in six provinces of China (autonomous regions) in 2001, with an average prevalence of 1.92. The risk factors of cerebral palsy are many, the cause of the causes is variety and complexity. In the last 140 years, Little describes the main causes of cerebral palsy, such as abnormal delivery, dystocia, and neonatal asphyxia. The result is widely recognized for a long time. However, in recent years, with the development of the study, the prenatal factors are considered to be the primary factors. Objective: To study the risk factors of cerebral palsy in the rural children of Zaozhuang City, to provide a reference for the prevention and treatment of cerebral palsy in Zaozhuang City, and to promote the children's cerebral palsy. Complex work. Methods:1-6-year-old children with all conditions in the investigated area were given a random cluster sampling method. The children with cerebral palsy were matched with 4 normal children according to the ratio of 1:4 as the case group, and the children with cerebral palsy were in danger of cerebral palsy. Risk factors analysis. The database is established by using the Epidata3.1 statistical software, and the software is used for statistical software of SPSS13.0. to be in series Results:1.1-6-year-old children were enrolled, and 36 children with cerebral palsy were diagnosed with cerebral palsy. The prevalence was 1.79%, with 5-6 years of age (excluding 6 years of age). The highest rate was 2.07%. There were 24 male children and 12 female children. The prevalence of male was slightly higher than that of female. 2.36 children with abnormal findings, 97.2% chose to diagnose and treat the local hospital, 94.4% had the diagnosis and treatment in the mother and child health care hospital, 72.2% of the cases chose a variety of ways to combine the rehabilitation mode, 94.4% of the local hospitals were unable to make the orthoses and auxiliary tools,6. 1.1% of the children with cerebral palsy were registered, but only 17.1% of the follow-up, 2.8% of the children established the monitoring file, the treatment cost of 97.2% of the children can be partially reimbursed, and 47.2% of the patients can The special economic support given by the government was obtained. In 3.36 children with cerebral palsy,24 cases of spastic type, 66.7%,6 cases of hypotonicity, 16.7%,3 cases of ataxia type, 8.3%, and 2 cases of non-casual sports. The results of single factor analysis showed that the factors of statistical significance were the father's age (> 30 years) (OR = 3.125), the family per capita annual income (OR = 2.802), family history of mental illness (OR = 12.000), and mother's family history (OR = 12.000). The number of passive smoking in the pregnant women (OR = 11.989), the number of passive smoking in the pregnant women (OR = 8.413), the number of pregnancies (OR = 4.206), the number of abortions (OR = 6.122), the history of premature labor (OR = 7.358), the extension of labor (> 24 hours) (OR = 12.000). The asphyxiation was 9 cases, accounting for 9 cases. The total number of cases was 25%, and the control group was not suffocation. The results of the multiple-factor conditional logistic regression analysis showed that 4 factors entered the equation, which were female's common cold (OR = 13.737), the number of passive smoking in the pregnant women (OR = 18.308), and the number of abortions (OR = 14.34). 7) and The history of premature birth (OR = 15.888). Conclusion:1. The prevalence of cerebral palsy in the rural area of Zaozhuang is 1.79%, which is close to the six provinces in China. -The prevalence of cerebral palsy in the 6-year-old was the average, with the most of the male.2. The children of 1-6 years of age in the rural area of Zaozhuang were selected to the local maternal and child health care hospital for diagnosis and treatment, and most of them were combined in a variety of ways. The way of rehabilitation; more children have been registered, but further 3. The clinical types of children with cerebral palsy from 1 to 6 years of age in the rural area of Zaozhuang are mainly of the type of spasm, and the other cases The main risk factors of children's cerebral palsy in the rural areas of Zaozhuang are: the suffocation, the flow
【學位授予單位】：吉林大學
【學位級別】：碩士
【學位授予年份】：2012
【分類號】：R742.3

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