【目的】 探讨全身运动质量评估技术对于高危新生儿随访中的临床应用价值。 【方法】 对253例在康复科随访的高危新生儿,分别在扭动运动阶段和不安运动阶段进行全身运动质量评估,在12月龄(纠正年龄)后根据临床诊断和Peabody运动发育量表确定其运动发育结局。分析其应用价值。 【结果】 扭动运动阶段的单调性运动的评估应用价值不高,只有痉挛-同步性运动有预测价值。痉挛-同步性运动对于脑瘫的预测敏感度72%,特异度99%,阳性预测值95%,阴性预测值92%。不安运动阶段异常运动中不安运动缺乏的预测价值高。不安运动缺乏对于脑瘫的预测敏感度100%,特异度96%,阳性预测值86%,阴性预测值100%。 【结论】 扭动运动阶段痉挛-同步性运动对于脑瘫有一定的预测价值,不安运动阶段不安运动缺乏对于高危儿运动发育结局,特别是脑瘫具有较好预测价值,全身运动质量评估在高危儿随访中应作为评估工具,临床上值得广泛推广。
Abstract
【Objective】 To investigate the clinical application value of qualitative assessment of general movements for high risk infants follow-up. 【Methods】 253 high risk infants follow-up in rehabilitation department were accepted the qualitative assessment of general movements respectively in the twist movements period and fidgety movements period.Motor developmental outcome was defined by clinical diagnosis and Peabody Motor Develoment Scale assessment after 12-month-age(corrected age of premature infants).Its application value was analysed. 【Results】 The monotonicity of twist movements period assessment value was not high,only the spasm -synchronous movements had prediction value of synchronicity.The predictive validity of cerebral palsy was as follows:sensitivity 72%,specificity 99%,positive predictive value 95%,and negative predictive value 92%.Fidgety movements lack in the irregular movement phase had the high predictive value of fidgety movements.The predictive validity of cerebral palsy was as follows:sensitivity 100%,specificity 96%,positive predictive value 86%,and negative predictive value 100%. 【Conclusions】 The spasm-synchronous movements of twist movements period have prediction value of synchronicity.Fidgety movements assessment for high risk infants have predictive value of motor developmental outcome,especially with cerebral palsy,clinical use should be extended in high risk infants follow-up as evaluation tool.
关键词
全身运动 /
扭动运动 /
不安运动 /
运动发育结局 /
脑性瘫痪 /
高危新生儿
Key words
general movement /
twist movements /
fidgety movements /
motor developmental outcome /
cerebral palsy /
high risk infant
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