目的 观察脑性瘫痪（CP）伴营养不良患儿进行系统性饮食调整的效果。方法 2015年1月—2022年1月我院收治以CP伴营养不良患儿80例,以随机数字表法分为对照组和研究组各40例,常规护理指导用于对照组,系统性饮食调整护理用于研究组。比较2组患儿在干预前、后的生化指标（白蛋白、血红蛋白、肌酐、低密度脂蛋白水平）、身体指标（体质量、身高、体质指数、腹部皮下脂肪厚度）、肠内营养混悬液使用剂量及饮食行为能力评分和患儿监护人对干预的满意率。结果 干预后2组的生化指标可见明显变化,其中研究组与对照组相比,白蛋白、血红蛋白、肌酐指标提升更多更平稳,而低密度脂蛋白研究组较对照组相比,降低更多更平稳,（P<0.01）。在干预后两组间的身体指标可见明显变化,其中研究组与对照组相比,体质量、体质指数、腹部皮下脂肪厚度较干预前增加更多更平稳,而低密度脂蛋白研究组较对照组相比,降低更多更平稳,（P<0.01）。在干预后2组的肠内营养混悬液使用剂量及饮食行为能力评分较干预前可见明显变化,其中研究组与对照组相比,肠内营养混悬液使用剂量及饮食行为能力降低更多更平稳（均P<0.05）。研究组监护人对干预的满意率高于对照组（P<0.05）。结论 在CP伴营养不良患儿中,开展有效的系统性饮食调整干预,可有效改善患儿的生化指标,提升各项身体指标,减少肠内营养混悬液的使用剂量,改善饮食行为能力,获得患儿监护人的认可,效果理想。

Objective To observe the effect of systematic diet adjustment in children with cerebral palsy（CP）and malnutrition．Methods A total of 80 CP children with malnutrition treated in our hospital（from January 2015 to January 2022）were divided into two groups by random number table method．Control group received routine nursing guidance and study group received systematic diet adjustment nursing．The biochemical indexes（albumin,hemoglobin,creatinine,low-density lipoprotein levels）,physical indexes（weight,height,body mass index,abdominal subcutaneous fat thickness）,the dosage of enteral nutritional suspension and the score of dietary behavior ability were compared between the two groups before and after the intervention．The satisfaction rate of the children's families with the intervention was evaluated．Results After the intervention,the biochemical indexes of the two groups showed significant changes．Compared with the control group,the indexes of albumin,hemoglobin and creatinine in the study group increased more and more stably,while the index of low-density lipoprotein in the study group decreased more and more stably（P<0.01）．After the intervention,the physical indexes of the two groups showed significant changes．Compared with the control group,the weight,body mass index and abdominal subcutaneous fat thickness of the study group increased more and more stably than before the intervention,while the low-density lipoprotein study group decreased more and more stably（P<0.01）．After the intervention,the dosage of enteral nutritional suspension and the score of dietary behavior ability in the two groups showed significant changes compared with those before the intervention．Compared with the control group,the immune indexes in the study group increased more and more stably,while the dosage of enteral nutritional suspension and the score of dietary behavior ability in the study group decreased more and more stably（P<0.05）．The satisfaction rate of family members in the study group was higher than that in the control group（P<0.05）．Conclusions In children with CP and malnutrition,carrying out effective systematic diet adjustment intervention can significantly improve the biochemical indexes of children,improve various physical indexes,improve immune ability,reduce the dosage of enteral nutritional suspension,improve dietary behavior,and obtain the recognition of children's family members,which has ideal effects．

目的 研究应用手机软件(Goniometer Pro,G-pro)进行测量髋关节活动度(range of motion,ROM)的测量的信度和效度。方法 用量角器和苹果手机软件G-pro来测量髋关节ROM,共有12名受试者参加本次试验。测量者A应用量角器和G-pro来测量髋关节的屈曲角度,同时测量者B应用G-pro进行再次测量髋关节屈曲角度,24 h后测量者A在相同条件下应用G-pro再次测试髋关节屈曲角度。通过分析量角器与G-pro测量结果进行效度分析,通过比较测量者A与B,测量者A前后两次测量进行组间和组内信度研究。结果 在同一测量者量角器与G-pro测量值之间无显著性差异(P >0.05),测量者A用G-pro前后24 h前后测量受试者得出的差值也无显著性差异(P>0.05),测量者A、B用G-pro测量髋关节活动度的测量值无显著性差异(P>0.05)。结论 G-pro对于测量髋关节屈曲具有良好的信度和效度。

Objective To study the reliability and validity of measuring hip joint range of motion(ROM) with mobile APP (Goniometer Pro,G-pro). Methods The hip joint ROM was measured with a protractor and iPhone APP (G-pro), 12 subjects participated in this trial. Tester A used a protractor and iPhone APP (G-pro) to measure the flexion angle of the hip joint. Tester B used the mobile APP to measure the hip flexion angle again. Twenty-four hours later, tester A used the mobile APP to measure the hip flexion angle again under the same conditions. The validity was evaluated by analyzing the measurement results of protractor and mobile APP. The inter group and intra group reliability was studied by comparing the two measurements of tester A and tester B, and twice measurements of tester A. Results There was no significant difference between the measurements of protractor and iPhone APP by the same tester (P＞0.05). There was no significant difference in the twice measurements of tester A using iPhone APP (P＞0.05), and there was no significant difference in measurements of tester A and tester B using iPhone APP (P＞0.05). Conclusions The iPhone APP (Goniometer Pro) has good reliability and validity in measuring hip ROM.

目的 观察家庭式康复教育结合模式对脑瘫儿童发育情况的影响。方法 采用随机数字表法将38例脑瘫患儿分为实验组及对照组。2组患儿均给予常规日常康复,康复治疗师、引导式教师、特殊教育教师组成的团队共同对实验组内儿童功能情况进行评估,设计引导式教育课程,对无康复教育知识背景的专职护理人员进行课程培训,完成培训的护理员具体执行引导式教育课程,每天2次,每次60min,每周介入6日,持续半年。于治疗前、治疗后采用Gesell发展量表进行评测。结果 治疗前,两组患儿适应性行为、大运动、精细动作、语言、个人-社会行为5个领域指标组间差异无统计学意义（P>0.05）;经介入半年后,两组患儿的适应性行为、大运动、精细动作、语言、个人-社会行为5个领域评分均优于组内治疗前水平（P <0.05）,且实验组优于对照组（P <0.05）。结论 家庭式康复教育结合模式,对改善脑瘫患儿的多方面功能发展有重要意义,值得在专业人才资源缺乏的机构和社会中推广、应用。

Objective To observe the effect of the model of family rehabilitation education on the development of children with cerebral palsy. Methods 38 children with cerebral palsy were divided into experimental group and control group by random digital table method. Two groups of children were given routine daily rehabilitation. A team of rehabilitation therapists,guided teachers and special education teachers assessed the children's function in the experimental group,and designed guiding education course. The team offered curriculum training for full-time nurses without background knowledge of rehabilitation education,and the trained nurses implemented the guiding education course twice each day,60 minutes each time,6 days per week. The training lasted for six months. The Gesell development scale was used for evaluation before and after treatment. Results Before treatment,there was no statistically difference between 2 groups of children in 5 areas of adaptive behavior,exercise,fine motor,language and personal social behavior （P >0.05）. After six months' intervention,2 groups of children were better than the pre-treatment level （P <0.05）. The experimental group was superior to the control group （P <0.05）. Conclusion The model of family rehabilitation education is of great significance to the improvement of the multifaceted function of children with cerebral palsy. It is worthy of popularization and application in institutions and societies which are lack of professional talent resources.