この文献の参照には次のURLをご利用ください : https://doi.org/10.15027/17749
広島大学医学雑誌 Volume 51 Issue 3/4/5/6
published_at 2003-12-28
ダウン症の長期追跡と療育支援の効果に関する研究 : 第1編 合併症,IQ,生活難易度に関する長期追跡
Study on the Long-term Prognosis of Patients with Down Syndrome and the Effects of Educational and Psychological Supports on Patient Life. : I. The relationship between intelligence quotient and the difficulty of daily life.
Yamane Kiyoko
Abstract
ダウン症児の長期的な発達状況・社会適応について,広島市児童療育指導センターを受診した解析可能な98名について,後方視的に検討した。センターでの療育支援を受けていない1974年4月以前の出生例34名(I群),児童療育指導センターで療育支援が始まった1974年4月以降出生例43名(II群),1985年4月以降に出生し早期療育を受けた21名(III群)の3グループに分類した。知能指数(IQ)はいずれの群においても年齢とともに低下し,3歳時の言語理解は早期療育を実施したIII群で良好であった。18歳でのI群・II群のIQは重度域が多かった。18歳でのI群・II群の生活難易度は,軽度から中等度が多かったが,I群に比較し,II群のほうが有意に軽度であり,IQおよび,療育的支援の有無に関係していた。また,18歳時における合併症は,先天性心疾患・てんかんなど小児期特有のものに加え,肥満,糖尿病,引きこもり,統合失調症など,思春期,青年期に特徴的な合併症の出現が認められた。しかし,合併症の有無とIQおよび生活における難易度に関連は認められなかった。以上より,ダウン症のQOLの向上には小児期から成人期に到るまでの医療・教育・福祉の包括的な支援の構築の重要性が示唆された。
Abstract
The long-term prognosis of patients with Down syndrome was retrospectively evaluated with a focus on the development of intelligence quotient (IQ) and social adaptation. The 436 Down syndrome patients eligible for this study had all consulted with the Hiroshima Child Guidance Center for Mental Physical Disabilities between April 1974 and March 1996. Of these, 98 patients were sampled and divided into three groups: Group I consisted of adults born before 1974 and who were not currently receiving educational or psychological supports. Groups II and III consisted of patients born after 1974 and who were treated in this center either without (Group II) or with (Group III) early medical and educational interventions. Diabetes mellitus, thyroid disease, and mood disorders were found in Groups I & II. Regardless of group, IQ decreased gradually with age. Language comprehension at the age of 3 years was best in Group III. The difficulties of daily life, which were mild to moderate in a majority of patients regardless of their group, depended on IQ and a history of receiving medical and educational supports. These findings suggest that the establishment of comprehensive healthcare management for Down patients is necessary from infancy through adulthood in order to improve their quality of life.
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Keywords
ダウン症
合併症
予後
知能指数
生活難易度
Other Article
PP. 105 - 106