摘要
目的探讨全身运动质量评估(GMA)在脑损伤高危新生儿(高危儿)脑发育随访中的应用.方法纳入脑损伤高危儿248例,分别在扭动运动阶段(周龄34~45周)、不安运动阶段(足月后9~20周)行GMA,纠正12个月龄时行Gesell评估、临床检查、诊断以确定发育结局.分析GMA的敏感度、特异度、阳性预测值和阴性预测值.结果248例高危儿的运动发育结局:脑瘫6例(2.42%),运动发育迟缓11例(4.44%),运动发育正常231例(93.15%).对运动发育异常预测:扭动运动结合不安运动预测不良运动发育结局(运动发育迟缓和脑瘫)的特异度为99.57%,敏感度为94.12%,阴性预测值99.57%,阳性预测值94.12%;扭动运动结合不安运动预测脑瘫发育结局的特异度为99.57%,敏感度为100%,阴性预测值99.57%,阳性预测值85.71%.结论高危儿GMA异常与纠正12个月龄的神经发育较差相关.GMA在预测高危儿运动发育结局中具有高度灵敏度和特异性,可在超早期识别出发育异常婴儿,为早期干预提供依据.
Objective To observe the application of general movements assessment(GMA)on neurodevelopment follow-up in high-risk infants.Methods 248 high-risk infants were enrolled,and received GMA at the writhing movements stage(34~45 weeks of age)and fidgety movements stage(9~20 weeks after term),respectively.At 12 months corrected age,neurodevelopment was assessed using Gesell assessment,clinical examination,and diagnosis.The sensitivity,specificity,positive predictive value and negative predictive value were analyzed.Results The motor development outcomes of 248 high-risk infants were as follows:cerebral palsy(6 cases)(2.42%),motor retardation(11 cases)(4.44%),and normal motor development(231 cases)(93.15%).Prediction of abnormal motor development:the specificity,sensitivity,negative predictive value and positive predictive value of prediction of adverse motor development outcomes(motor retardation and cerebral palsy)by writhing movement combined with fidgety movement were 99.57%,94.12%,99.57% and 94.12% respectively.The specificity,sensitivity,negative predictive value and positive predictive value for cerebral palsy were 99.57% and 100%,respectively.The specificity,sensitivity,negarive predictive value and positive predictive value of prediction of cerebral palsy outcomes by writhing movement combined with fidgety movement were 99.57%,100%,99.57% and 85.71% respectively.Conclusion Abnomial GMA in high-risk infants is associated with poorer neurodevelopment at corrected 12 months of age.GMA has high sensitivity and specificity in predicting motor development outcomes,and can identify developmental abnormalities in infants at ultra-early stage,providing an evidence for early intervention.
出处
《浙江临床医学》
2022年第1期72-74,共3页
Zhejiang Clinical Medical Journal
基金
温州市科技计划项目(2018Y1468)。
关键词
全身运动质量评估
Gessll量表
高危儿
运动发育结局
预测效度
General movements assessment(GMA)
Gesell development scale(GDS)
High-risk infant
Motor development outcome
Predictive validity
