Serebral Palsili hastalarda fonksiyonel durum, Serebral palsi tipi ve antropometrik parametrelerin ilişkisi

Year 2020, Volume: 14 Issue: 5, 417 - 421, 29.09.2020

İlkay Karabay , Hüma Bölük Şenlikci , Fatma Gülçin Ural , Tülay Tiftik , Murat Ersöz , Selami Akkuş

https://doi.org/10.12956/tchd.674754

Abstract

Giriş: Serebral palsili çocuklarda büyüme geriliği çok yaygın olup en önemli nedeni malnutrisyondur. Çalışmanın amacı serebral palsili hastaların demografik yapılarını ortaya koymak ve büyüme geriliğine etkili faktörleri tartışmaktır.
Gereç ve yöntem: Çalışmaya hastanemizde yatarak rehabilitasyon programı alan 48 serebral palsi tanısı almış, 2-14 yaş arası hasta dahil edildi. Hastaların yaş, cinsiyet, etyoloji, klinik SP tipi ve eşlik eden sorunları kaydedildi. Hastaların fonksiyonel durumları Gross motor function classification system (GMFCS)’e göre belirlendi. Beslenme problemi veya beslenme desteği olup olmadığı, günlük kalori ihtiyacı belirlendi. Hastaların boy, kilo, baş çevresi, kol çevresi ölçümleri yapıldı, vücut kitle indeksleri (VKI) hesaplandı.
Bulgular: Hastaların %56.2’si kız ve %43.8’i erkek ve yaş ortalaması 6.031±2.7 (2.3-13.5) yıl idi. Hastalar klinik tiplere göre ayrıldığında 19(39.6) hasta diplejik ve 29(%60.4) hasta kuadriplejik tipti. 28(%58.3) hasta non –ambule ve 19(%41.7) ambule idi.Hastaların baş çevresi 48.1±7.5 cm, kol çevresi 16.4±2.6 cm, kalça çevresi 52.1±5.9, bacak uzunluğu 22.8±3.5 ve cilt kalınlığı 22.4±1.1 cm olarak ölçüldü. Boy ve kilo persentili 10 ve altında olan hastalar sırasıyla %63.8 ve %57.4 ve vücut ağırlık persentiline (VAP) göre 15 ve altında olan hasta %48.9 idi. Hastalarda beslenme problemleri olarak sırasıyla %6.3 gastro-özofagieal reflü, %14.6 yutma güçlüğü, %33.3 salya akıtma ve % 68.8 diş problemi tespit edildi. Hastaların %56.3’ü beslenme desteği (pediasure) kullanıyordu. Aynı şekilde hastaların annelerinin %93.8’i ev hanımı ve %62.5’i ilkokul mezunu idi.
Sonuç: Büyüme geriliği normal populasyona kıyasla serebral palsi hastalarında yaygındır. Malnutrisyon en sık görülen nedeni olup, bunun için de birçok risk faktörü mevcuttur.

Keywords

serebral palsi, malnutrisyon, büyüme geriliği

Relationship between functional status, Cerebral palsy subtype and anthropometric parametres in Cerebral Palsied children

Abstract

Growth retardation is shown in patients with cerebralpalsy (CP) and most important cause is be malnutrition. The aim of the current study is to reveal socio-demographic characteristics of CP patients and relationship between anthropometric parametres and functionality.
Material and Methods: Total of 48 CP patients, between 2-14 years-old admitted to our inpatient clinic, are included in the study. Age, gender, etiology, CP subtype and co-morbidities were recorded. Functional status of the children were recorded according to the Gross motor function classification system (GMFCS). Weight, height measurements were done, body mass index (BMI) and Z-scores were calculated.
Results: Of the patients 56.2% were female and 43.8% were male with 6.0±2.7 (2.3-13.5) (mean±SD) years mean age. Totally, 19 patients (39.6%) were classified as diplegic and 29 patients (60.4%) were classified as total type CP. Total of 28 (58.3%) patients were non-ambulatory and 20 (41.7%) patients were ambulatory. Patients with height and weight 3th percentile and below were 46.3% and 34% of all, respectively. The BMI percentile of the patients accoding to the 5th percentile and below were 31.9% of total. Of the patients 68.8% had teeth problems, 33.3% had sialorrhea, 14.6% had dysphagia and 6.3% had gastro-esophageal reflux as nutritional problems.
Conclusion: Growth retardation is more common in patients with cerebral palsy and has multiple reasons. Nutritional parameters is used to assess growth. We did not detect significant difference between functionality, CP type and body weight, height and BMI Z- scores in CP patients.

Keywords

Body height, Malnutrition, Cerebral palsy, Body weight

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