目的 对高危儿早期全身运动质量(GMs)评估法和新生儿行为神经测定(NBNA)方法的一致性进行分析。方法 选取2017年1月-2018年1月甘肃省妇幼保健院出生在儿童保健科随访的有高危因素的患儿,选择完成GMs扭动阶段评估,并同时进行NBNA测评的研究对象共706例。分析2种评估方法的一致性Kappa值。结果 足月、正常出生体重儿GMs评估正常检出率高于早产及低出生体重儿(P＜0.05)。早产患儿痉挛-同步性GMs检出率显著高于足月儿(P=0.043)。随着胎龄及出生体重的降低,异常的GMs检出率呈上升趋势,差异有统计学意义(P＜0.05)。不同出生胎龄及出生体重下NBNA评分与GMs评估有一定的相关性,Kappa值为0.112~0.289、0.118~0.194(P＜0.05)。结论 不同出生胎龄及出生体重下NBNA评分与GMs评估的一致性有待于进一步探讨。两种方法相互不能取代,联合应用可更全面评价高危儿脑发育及脑损伤的情况,促进患儿的运动功能及社会适应性。
Abstract
Objective To study the consistency between general movements (GMs) assessment and neonatal behavioral neurological assessment (NBNA) results in high-risk infants. Methods Totally 706 high-risk infants born in the Gansu Provincial Maternity and Childcare Hospital from January 2017 to January 2018 and followed up in Child Healthcare Department were enrolled in this study. All infants were assessed at twisting movement stage and finished NBNA neurological assessment. Kappa value of the two methods was calculated to analyze the consistency. Results The normal detection rate of GMs in full-term and normal birth weight infants was higher than that of premature and low birth weight infants (P＜0.05). And the detection rate of cramped-synchronized GMs in preterm infants was significantly higher than that in term infants (P=0.043). With the decrease of gestational age and birth weight, the detection rate of abnormal GMs presented an increasing trend significantly (P＜0.05). There were certain correlations between NBNA result and GMs assessment at different gestational age and birth weight groups, and the Kappa values were 0.112-0.289, 0.118-0.194 (P＜0.05). Conclusions The consistency of NBNA score and GMs assessment result at different gestational age and birth weight groups still needs to be further discussed. Moreover, the two methods cannot be replaced by each other. Combined application can evaluate the brain development of high-risk infants comprehensively, and promote their motor development and social adaptability.
关键词
高危儿 /
全身运动质量评估 /
新生儿行为神经测定
Key words
high-risk infants /
general movements assessment /
neonatal behavioral neurological assessment
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基金
甘肃省科技支撑计划(1304FKCA076)
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