Current situation on epidemic characteristics, standardization prevention and treatment of children with cerebral palsy in Qinghai province / 中华实用儿科临床杂志

ABSTRACT

Objective To study the incidence and prevalence in the children aged 1-2 years and 1-6 years with cerebral palsy(CP) in Qinghai province,and to identify the epidemiological characteristics and control status of the children with CP.Methods A stratified cluster random sampling method was used to conduct epidemiological survey of 10 000 children in Qinghai province.Children diagnosed as CP were asked to fill in the CP questionnaires,including children's development,and the status of prevention and treatment of CP.Compared with the children diagnosed as CP,4 healthy children at the same age were asked to fill in the questionnaires related to children's development.SPSS 15.0 statistical software was used for data analysis.Results Seven children with CP were diagnosed at the aged 1-2 years,and the total incidence rate was 3.3‰(7/2 148 cases).The incidence between the urban (0) and the rural areas (12‰) (7/582 cases) was significantly different(P =0.000 1),while there was no significant difference statistically between boys (5 cases) and girls (2 cases) (P ＞ 0.05).Fifty-four children with CP were diagnosed at the age of 1-6 years,and the total prevalence rate was 5.4‰(54/10 000 cases).The prevalence between the urban (2.3‰,17/7 348 cases) and the rural areas (13.9‰,37/2 652 cases) was statistically different (x2 =49.144,P ＜ 0.01),while there was no significant difference statistically between boys (31 cases) and girls (23 cases) (P ＞ 0.05).The proportions of various types of CP were as follows29 cases(53.70％) of spastic type,9 cases(16.67％) of hypotonia,7 cases (12.96％) of mixed type,4 cases (7.41％) of ataxia,3 cases (5.56％) of rigidity and2 cases (3.70％) of dyskinetic,respectively.Among the spastic types,there were 16 cases (55.17％)of spastic quadriplegia,6 cases (20.69％) of spastic hemiplegia,4 cases (13.79 ％) of spastic diplegia,2 cases (6.89 ％) of spastic monoplegia and 1 case (3.45％) of spastic triplegia,respectively.The top three risk factors were premature (13 cases,24.1％),hypoxic-ischemic encephalopathy (9 cases,16.7％) and maternal threatened abortion (8 cases,14.8％).The first three complications were mental retardation,language dysfunction and epilepsy.Conclusions The incidence and prevalence of CP in children in Qinghai province are very high,which is higher in the rural areas than that in the urban areas.The most common CP is spastic type.The main risk factors for CP are preterm labor,hypoxic-ischemic encephalopathy and maternal threatened abortion.Intellectual disability,speech disability and epilepsy are the most common complications of CP.Maternal and perinatal infant health care and early intervention need to be further strengthened.