1.Dysphagia in Cerebral Palsy and the Relationship between Levels of Gross Motor Function Classification System
Yanping JIANG ; Mei HOU ; Tanfeng DOU ; Wenyan LI ; Huijuan YANG
Chinese Journal of Rehabilitation Theory and Practice 2010;16(12):1169-1171
ObjectiveTo analyze the characteristics of dysphagia in children with cerebral palsy and explore the relation with the gross motor function classification.MethodsThe children with cerebral palsy in our rehabilitation center from June 2009 to June 2010 were assessed by Dysphagia Disorders Survey(DDS), Oral Motor Assessment and Gross Motor Function Classification System (GMFCS) to explore the relationship between the dysphagia disorders and different gross motor levels.ResultsOf all 105 children with cerebral palsy, 21.9% were mild dysphagia, and 34.3% were moderate to severe dysphagia, resulting in a prevalence of dysphagia of 56.2%. DDS and oral motor scores were changed by GMFCS levels. The correlation coefficient were 0.767 and -0.504 between DDS, oral motor scores and GMFCS, 0.55 and 0.27 between dysphagia, oral motor disorder and the gross motor functions, respectively(P<0.01).ConclusionDysphagia was positively related to severity of motor impairment. Children in GMFCS levels Ⅳ~Ⅴ almost with problems in the pharyngeal and esophageal phases, apparently on the DDS, should be referred for appropriate clinical evaluation of swallowing function.
2.Cerebral palsy in children with prematurity and its comorbidities
Dianrong SUN ; Mei HOU ; Wenyan LI ; Tanfeng DOU ; Rong YU ; Ke WANG
Chinese Journal of Physical Medicine and Rehabilitation 2010;32(12):911-914
Objective To analyze the comorbidities and gross motor function classifications (GMFCs) of premature children with cerebral palsy (CP) in terms of neurological subtype and gestational age in search of some relationship. Methods Children with cerebral palsy treated at the Qingdao Children's Hospital from 2006 to mid2009 received intelligence capacity tests, ophthalmological consultations, language/speech tests, brainstem auditory evoked potential measurements, electroencephalograms and GMFC evaluations. All of the children were stratified according to neurological subtype, gestational age, comorbidities and gross motor function classification. Results Of all 258 children, spastic diplegic cerebral palsy predominated (183 case, 70.9% ). 124 cases (48.1% ) had visual disorders, 121 (46.9%) had language or speech disorders and 103 (39.9%) showed mental retardation. The frequencies of individual comorbidities were distributed disproportionately between the different neurologic subtypes.GMFC levels also differed with the different CP types. The GMFC levels of diplegics were significantly better than those of the other types. The distribution of comorbidities such as visual disorders, language or speech disorders, and mental retardation was not related to gestational age or type of CP. Conclusions There is some correlation between the neurological subtype, comorbidities and the GMFC levels. But there is no significant correlation between gestation age and the severity of CP.
3.Duration and risk factors of invasive mechanical ventilation after neonatal abdominal surgery under general anesthesia
Hong WANG ; Chanjuan KUANG ; Wenyan DOU ; Yanan ZHANG ; Jinshi HUANG ; Mingyan HEI
Chinese Journal of Neonatology 2023;38(10):582-586
Objective:To study the duration of invasive mechanical ventilation (MV) and its influencing factors after neonatal abdominal surgery under general anesthesia in neonatal intensive care unit (NICU).Methods:From January 2018 to December 2020, neonates received abdominal surgery under general anesthesia and needed endotracheal intubation and MV after surgery in NICU of our hospital were retrospectively studied. According to MV duration, the neonates were assigned into <72 h group and ≥72 h group. Multivariate logistic regression was used to analyze the risk factors of postoperative MV duration.Results:A total of 113 neonates were enrolled, including 57 male (50.4%) and 56 female (49.6%). The gestational age was (35.7±3.6) weeks, the birth weight was (2 497±933) g, the average operation age was 9.9(3.6, 22.2) d and the average hospital stay was 22.0(12.0,37.0) d. Congenital intestinal obstruction (37/113, 32.7%) was the most common diagnoses on discharge, followed by neonatal necrotizing enterocolitis(28/113,24.8%) and gastrointestinal perforation (18/113,15.0%). The duration of operation was 80.0 (55.8,117.3) min. All neonates needed MV with endotracheal intubation. The duration of postoperative respiratory support was 30.0(7.0,84.5) h. 48 neonates (42.5%) had endotracheal intubation removed within 24 h after surgery. Multivariate logistic regression analysis showed that preoperative respiratory support ( P=0.004), congenital heart disease( P=0.013) and intravenous midazolam ( P=0.032) were independent risk factors for prolonged postoperative MV. Conclusions:The need of preoperative respiratory support, congential heart disease and intravenous midazolam were independent risk factors for the duration of postoperative MV after neonatal abdominal surgery under general anesthesia.
4.Perioperative nursing care of a newborn with bacterial corneal ulcer undergoing corneal transplantation
Huan WANG ; Jingjing WANG ; Wenyan DOU ; Xuhong WU
Chinese Journal of Nursing 2024;59(4):465-468
To summarize the perioperative nursing experience of a newborn with bacterial corneal ulcer undergoing corneal transplantation.Preoperative nursing points:to strengthen eye observation and protection to avoid corneal perforation;to properly administer systemic and eye medication to control infection.Postoperative nursing points:to closely observe the condition of corneal grafts to prevent postoperative complications;to provide eye drops on time after surgery to ensure medication safety;to emphasize pain management and provide nutritional support;to provide targeted health education to parents to ensure that the patient receives continuous care.Through multidisciplinary team collaboration,meticulous treatment and care,the corneal graft of the patient was clear,the suture was not loose,and there was no bleeding in the anterior chamber after 1 week of corneal transplantation.The vital signs were stable,and the patient was discharged from the hospital,and ophthalmic follow-up was conducted.After 7 weeks of surgery,the suture was successfully removed and the corneal transplantation was successful.