先天性多发性关节炎伴上肢损伤的学龄前儿童的言语发展研究

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论证。在儿童早期诊断出的运动发育困难或严重违规，是儿童语言发展进一步问题的预后标志之一。

目的是研究先天性多发性关节挛缩症及上肢病变患儿语言发育的特点。

材料与方法。从2020年到2021年，在H. Turner National Medical Research Center for Children’s Orthopedics and Trauma Surgery对21名诊断为先天性多发性关节弯曲和上肢病变的学龄前儿童（平均年龄为5.16±1.49岁）进行了语言治疗检查。所有患者按年龄分为两组：第一组包括10人—中青年学前班儿童（平均年龄为3.81±0.63岁），第二组包括11人—大龄学前班儿童（平均年龄为6.39±0.78岁）。对所得数据进行统计处理。

结果。大多数先天性多发性关节炎患儿有语言病变（90.5%），其中语言发育障碍比语言发育迟缓占主导地位（分别为78.9%和21.1%）。先天性多发性关节挛缩患儿围生期脑病发生率高（80.9%），有较多围产期病史（57.1%），早期运动或语言发育迟缓（分别为100%和52.4%）。这是他们进一步发展为语言障碍的先决条件。关节挛缩患者的发音器官结构先天性病理发生率高（57.1%），也是言语发育的不利因素。普遍形式的先天性多发性关节挛缩见于76.2%的儿童，孤立性上肢病变占23.8%。不同形式的先天性多发性关节挛缩患者的言语病理形态差异无统计学意义。将两个年龄组的学龄前儿童先天性多发性关节挛缩症患者进行有无言语病理的比较，发现第一年龄组儿童有90%的病例存在言语障碍，第二年龄组儿童有90.9%的病例存在言语障碍。从言语病理的形式来看，第一组患儿中既有语言发育障碍，也有言语发育迟缓（分别为55.6%和44.4%），而第二组患儿中只有语言发育障碍（100%）。在两个年龄组的儿童中，构音障碍在语言病理学的临床形式中占主导地位（80%）。

结论。先天性多发性关节挛缩症患儿的语言障碍及上肢病变提示有此病理的患者需要进行早期语言治疗检查并及时纠正语言。

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作者简介

Olga Agranovich

H.Turner National Medical Research Center for Children's Orthopedics and Trauma Surgery

Email: olga_agranovich@yahoo.com
ORCID iD: 0000-0002-6655-4108
SPIN 代码: 4393-3694
Scopus 作者 ID: 56913386600
Researcher ID: B-3334-2019
http://www.rosturner.ru/kl10.htm

MD, PhD, D.Sc., head of the department of arthrogryposis, member of the Paediatric Hand International Society Of Surgeons (PHISOS),  Federation of European Societies for Surgery of the Hand (FESSH), The International study group on arthrogryposis

俄罗斯联邦, 64-68 Park Street, St. Petersburg, Pushkin, 196603

Zoya Agranovich

State Healthcare Institution Center for Restorative Treatment “Child Psychiatry” named after S.S. Mnukhin

Email: barsik1966@mail.ru
ORCID iD: 0000-0003-1622-7114
俄罗斯联邦, Saint Petersburg

Evgeniya Ermolovich

H. Turner National Medical Research Center for Children’s Orthopedics and Trauma Surgery

Email: dr.lazareva@bk.ru
ORCID iD: 0000-0001-6716-1034
SPIN 代码: 6598-5653

MD, neurologist

俄罗斯联邦, 64-68 Parkovaya str., Pushkin, Saint Petersburg, 196603

Ekaterina Petrova

H. Turner National Medical Research Center for Children’s Orthopedics and Trauma Surgery

Email: pet_kitten@mail.ru
ORCID iD: 0000-0002-1596-3358
SPIN 代码: 2492-1260
Scopus 作者 ID: 57194563255

MD, PhD

俄罗斯联邦, 64-68 Parkovaya str., Pushkin, Saint Petersburg, 196603

Ildar Iskandarov

Kazan State Medical University

Email: iskandarov.ildar@gmail.com
ORCID iD: 0000-0002-4983-1150
SPIN 代码: 7154-7420

MD, PhD

俄罗斯联邦, 49, st. Butlerova, Kazan, 420012

Dmitry Ivanov

Kazan State Medical University

Email: i.dmitry1988@gmail.com
ORCID iD: 0000-0002-4150-5908
SPIN 代码: 9530-1505
Scopus 作者 ID: 57217735969
俄罗斯联邦, 49, st. Butlerova, Kazan, 420012

Anna Shestakova

National Research University “Higher School of Economics”

Email: a.shestakova@hse.ru

PhD

俄罗斯联邦, Moscow

Evgeniy Blagoveschenskiy

H. Turner National Medical Research Center for Children’s Orthopedics and Trauma Surgery; National Research University “Higher School of Economics”

编辑信件的主要联系方式.
Email: eblagovechensky@hse.ru
ORCID iD: 0000-0002-0955-6633
SPIN 代码: 2811-5723
Scopus 作者 ID: 6506349269
Researcher ID: B-5037-2014

PhD

俄罗斯联邦, 64-68 Parkovaya str., Pushkin, Saint Petersburg, 196603; Moscow

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2. 图 1 患有先天性多发性关节炎的第一年龄组儿童的语言发展水平。SDD—言语发展迟缓；LDD—语言发育障碍

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3. 图 2 先天性多发性关节挛缩和语言发育障碍的第一年龄组儿童言语病理的形式

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4. 图 3 患有先天性多发性关节炎的第二年龄组儿童的语言发展水平。LDD—语言发育障碍

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5. 图 4 先天性多发性关节挛缩和语言发育障碍的第二年龄组儿童言语病理的形式

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