摘要目的 了解先天性心脏病(CHD)患儿运动、认知及言语发育情况,为指导CHD患儿的功能康复提供依据.方法 选择6岁以下113例CHD患儿,应用Peabody运动发育量表(PDMS-2)测定其粗大运动功能、精细运动功能,应用Gesell测定其认知及言语能.应用粗大运动发育商(GMQ)、精细运动发育商(FMQ)、总体运动发育商(TMQ)、适应性发育商(适应性DQ)、言语发育商(言语DQ)、个人社交发育商(个人社交DQ)进行分析,并根据CHD患儿诊断将患儿分为房间隔缺损、室间隔缺损、肺动脉狭窄、动脉导管未闭、其他CHD 5组,比较各组间各发育指标的差异及男女患儿各项发育指标的差异.结果 113例CHD患儿中粗大运动功能:非常差占3.5％(4/113例),差占11.5％(13/113例),中等偏下占29.2％(33/113例),中等占55.8％ (63/113例);精细运动功能:非常差占1.8％(2/113例),差占4.4％(5/113例),中等偏下占16.8％(19/113例),中等占66.4％(75/113例),中等偏上占10.6％(12/113例);总运动功能:非常差占3.5％(4/113例),差占7.1％(8/113例),中等偏下占15.9％(18/113例),中等占73.5％(83/113例).适应性发育迟滞占15.9％(18/113例),言语发育迟滞占16.8％(19/113例),个人社交发育迟滞占10.6％(12/113例);适应性、言语、个人社交发育处于边缘水平的分别占15.9％(18/113例)、15.9％(18/113例)、19.5％(22/113例).其他CHD组患儿GMQ、TMQ与房间隔缺损组、室间隔缺损组、肺动脉狭窄组、动脉导管未闭组比较差异均有统计学意义(P均＜0.01),其他CHD组患儿FMQ与房间隔缺损组、室间隔缺损组、肺动脉狭窄组、动脉导管未闭组比较差异均有统计学意义(P均＜0.05),且其他CHD组患儿GMQ、FMQ、TMQ低于余4组;各组间适应性DQ、言语DQ、个人社交DQ差异均无统计学意义(P均＞0.05).结论 CHD患儿存在运动、认知、言语发育落后,且其他CHD组患儿GMQ、FMQ、TMQ发育落后更显著,需加强对CHD患儿的运动、认知、言语发育的评估与康复.

abstractsObjective To investigate the development in motor,cognition and language of children with congenital heart disease(CHD),and to guide the functional rehabilitation of children with CHD.Methods Peabody developmental scales-2 (PDMS-2) was used to evaluate the gross and fine motor development in 113 children with CHD (age:0-6 years old),and Gesell was used to evaluate their cognition and language development.The gross motor quotient (GMQ),fine motor quotient (FMQ),total motor quotient (TMQ),adaptability developmental quotient (DQ) and language DQ,personal-social DQ of the children were analyzed.According to the diagnosis of the children with CHD,children were divided into 5 groups:atrial septal defect,ventricular septal defect,pulmonary stenosis,patent ductus arteriosus,and other CHD.The differences in the growth indexes among groups were compared,and the difference between the male and the female children was compared.Results Of 113 children with CHD,3.5 ％ (4 cases) children had very poor gross motor function,11.5％ (13 cases) poor,29.2％ (33 cases) lower middle,and 55.8％ (63 cases) medium.Fine motor function:1.8 ％ (2 cases) children had very poor function,4.4％ (5 cases) poor,16.8 ％ (19 cases)lower middle,66.4％ (75 cases) medium,and 10.6％ (12 cases) upper middle.Total motor function:3.5％ (4 cases)children had poor motor function,7.1％ (8 cases) poor,15.9％ (18 cases) lower middle,and 73.5％ (83 cases) medium.The abnormal rate was 15.9％ (18 cases),16.8％ (19 cases),10.6％ (12 cases) in adaptive,language and personal-social with Gesell separately,and 15.9 ％ (18 cases),15.9％ (18 cases),and 19.5 ％ (22 cases) of CHD children at the edge level separately.GMQ,FMQ,TMQ in the children with other type of CHD were lower than those in the other 4 groups (atrial septal defect,ventricular septal defect,pulmonary stenosis,patent ductus arteriosus),and the differences were statistically significant(P ＜ 0.01,with GMQ and TMQ;P ＜ 0.05,with FMQ).And adaptability DQ,language DQ,personal-social differences among each group were no statistically significant (all P ＞ 0.05).Conclusions Children with CHD have delayed in motor,cognition and language.The delay of GMQ,FMQ and TMQ in the other CHD group is more significant.The development assessment and rehabilitation education should be conducted in the children with CHD.