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目的利用社交反应量表(social responsiveness scale,SRS)对门诊癫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门诊就诊的4~18岁癫患儿及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,收集癫患儿病史及临床资料,并对癫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。结果癫组SRS总分及5个维度得分均高于对照组(χ2=11.92,P<0.05)。癫组内SRS筛查阳性患儿在SRS5个维度得分均明显高于癫组内SRS筛查阴性患儿(P<0.000 1)。癫组各临床特点中,早发癫(癫首发年龄≤2岁,χ2=5.26,P=0.02)和智力低下(χ2=30.04,P<0.000 1)与SRS筛查阳性相关。结论与正常儿童相比,癫患儿存在社交沟通缺陷,提示临床应对癫患儿进行常规的社交沟通能力评估,以加强对小儿癫的综合管理。
Objective To screen the social communication ability of outpatients with epilepsy using the social responsiveness scale (SRS), and to carry out a preliminary study on the related factors of screening and evaluation results. Methods From September 2013 to March 2014, a case-control study was conducted in children aged 4-18 years with epilepsy and children aged 6-12 years with epilepsy clinics in the pediatric hospital affiliated to Fudan University. Their parents filled in the SRS scale to collect the history and clinical data of children with epilepsy. The screening results, social reaction characteristics and related factors of children with epilepsy and normal school children were compared and analyzed. Results The scores of SRS and 5 dimensions in epilepsy group were higher than those in control group (χ2 = 11.92, P <0.05). The SRS screening positive children in the epilepsy group scored significantly higher than the SRS screening negative children in the epilepsy group (P <0.000 1). Among the clinical characteristics of the epilepsy group, the incidence of early onset epilepsy (epileptic onset ≤2 years, χ2 = 5.26, P = 0.02) and mental retardation (χ2 = 30.04, P <0.0001) were positively correlated with SRS screening. Conclusion Compared with normal children, there are social communication defects in children with epilepsy, suggesting that clinical treatment of epilepsy should be routinely evaluated in social communication ability in order to strengthen the comprehensive management of pediatric epilepsy.