脑瘫儿童进食功能分级系统及营养不良分析

doi:10.11852/zgetbjzz2021-1690

摘要/Abstract

摘要： 目的对脑瘫儿童以进食功能分级系统(EDACS)进行评估,研究EDACS与粗大运动功能分级系统(GMFCS)的相关性,分析EDACS级别对营养不良检出结果的影响。方法对2021年1—4月就诊于安徽省儿童医院康复科的81例脑瘫儿童分别采取EDACS及GMFCS进行评估,并采用儿童生长发育Z评分进行营养评估,使用Kendall系数分析EDACS与GMFCS级别相关性,并用χ²检验分析EDACS级别对营养不良状况的影响。结果 EDACS分级结果为:Ⅰ级37例(45.7%)、Ⅱ级26例(32.1%)、Ⅲ级16例(19.8%)、Ⅳ级2例(2.5%)、Ⅴ级0例(0.0%);GMFCS分级结果为(由于有9例拒检,合计72例):Ⅰ级26例(36.1%)、Ⅱ级17例(23.6%)、Ⅲ级11例(15.3%)、Ⅳ级9例(12.5%)、Ⅴ级9例(12.5%)。EDACS与GMFCS的Kendall相关系数为K_τ=0.345,具有弱正相关性P(双尾)=0.001。采用EDACS分类的进食正常和进食困难的脑瘫儿童,其营养不良的检出率差异有统计学意义(χ²=6.359,P＜0.05)。结论对于脑瘫儿童,EDACS分级与GMFCS分级具有弱正相关性,同时EDACS级别对于营养不良也有影响,因此可将EDACS作为GMFCS的有益补充,有助于脑瘫儿童生长发育及营养状况的全面评估。

关键词: 脑瘫, 进食功能分级系统, 粗大运动功能分级系统, WHO儿童生长发育Z评分

Abstract: Objective To analyze the correlation between Eating and Drinking Ability Classification System (EDACS) and Gross Motor Function Classification System (GMFCS) by assessing children with cerebral palsy (CP), and to analyze the influence of different grades of EDACS on the malnutrition status of CP children. Methods A total of 81 children with CP who received treatment in the Department of Pediatric Rehabilitation of Anhui Children's Hospital from January to April 2021 were enrolled in this study, and were assessed with EDACS and GMFCS. World Health Organization Child Growth Standards Z scores were used to assess the malnutrition status for each CP child. Kendall tau_b correlation analysis was used to analyze the correlation between EDACS and GMFCS levels. χ²test was used to analyze the influence of EDACS levels on the detection of malnutrition verified with the Z scores. Results In terms of EDACS, there were 37 cases of grade Ⅰ (45.7%), 26 cases of grade Ⅱ(32.1%), 16 cases of grade Ⅲ (19.8%), 2 cases of grade Ⅳ (2.5%) and 0 case of grade Ⅴ (0.0%) . There were only 72 cases who accepted the GMFCS assessment, and 26 cases of grade Ⅰ (36.1%), 17 cases of grade Ⅱ (23.6%), 11 cases of grade Ⅲ (15.3%), 9 cases of grade Ⅳ (12.5%), 9 cases of grade Ⅴ (12.5%). The Kendall tau-b coefficient between EDACS and GMFCS was 0.345 (P<0.01), showing weak positive correlations. There was significant difference on the detection rate of malnutrition between children with and without eating disorders classified by EDACS(χ²=6.359,P＜0.05). Conclusions For CP children, EDACS levels are weakly and positively correlated with GMFCS levels. EDACS level also has influence on malnutrition of CP children. Therefore, EDACS could be considered as a helpful complementary assessment for CP children besides GMFCS, which will be helpful for comprehensive assessment on CP children's growth and nutrition status.

Key words: cerebral palsy, Eating And Drinking Ability Classification System, Gross Motor Function Classification System, WHO child growth standards Z score

中图分类号:

R742.3

陈婧, 童光磊. 脑瘫儿童进食功能分级系统及营养不良分析[J]. 中国儿童保健杂志, 2022, 30(5): 544-547.

CHEN Jing, TONG Guang-lei. Eating and Drinking Ability Classification System and malnutrition analysis of children with cerebral palsy[J]. Chinese Journal of Child Health Care, 2022, 30(5): 544-547.

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