《国际专家建议:需立即转诊进行脑性瘫痪诊断评估的临床特征》解读

胡斌, 牟瑞, 唐婉秋, 王成举, 张雨平

中国当代儿科杂志 ›› 2021, Vol. 23 ›› Issue (4) : 328-331.

PDF(1062 KB)
HTML
PDF(1062 KB)
HTML
中国当代儿科杂志 ›› 2021, Vol. 23 ›› Issue (4) : 328-331. DOI: 10.7499/j.issn.1008-8830.2012174
标准·方案·指南

《国际专家建议:需立即转诊进行脑性瘫痪诊断评估的临床特征》解读

  • 胡斌, 牟瑞, 唐婉秋, 王成举, 张雨平
作者信息 +

Interpretation of the international expert recommendations of clinical features to prompt referral for diagnostic assessment of cerebral palsy

  • HU Bin, MOU Rui, TANG Wan-Qiu, WANG Cheng-Ju, ZHANG Yu-Ping
Author information +
文章历史 +

摘要

近年来在国家政策的引导和支持下,社区医疗体系得到空前发展,其中,初级儿童保健在社区医院常规开展,大大缓解了儿童专科医院及二三级综合医院儿科的压力。但由于社区医疗机构儿童初级保健人员未接受专业培训,对脑性瘫痪(简称脑瘫)儿童早期出现的症状不能识别,常导致脑瘫患儿不能得到及早诊断和有效干预,从而影响预后。2020年在Development Medicine and Child Neurology发表的一篇专门针对社区医疗机构的早期脑瘫识别和转诊的国际专家建议,明确提出了应立即转诊的6个临床特征和应加强监测的2个“警告信号”,以及在转介给医学专家进行脑瘫诊断的同时,应考虑转介给其他专业人员的5个转诊建议。该建议有助于社区医疗机构儿童初级保健人员及早发现脑瘫高危儿,及时转诊并减少干预的延迟。该文结合国内的实际情况对该建议进行解读,以期提高我国社区医疗机构儿童初级保健人员识别脑瘫高危信号及合理转诊的能力,达到早发现、早诊断、早干预,改善脑瘫儿童预后。

Abstract

Under the guidance and support of national policies in recent years, the community medical system has been developed rapidly, among which primary child healthcare is carried out routinely in community hospitals, greatly alleviating the pressure of specialized pediatric hospitals and departments of pediatrics in secondary and tertiary general hospitals. However, due to the lack of professional training for primary child healthcare personnel in community medical institutions, early symptoms of children with cerebral palsy cannot be identified and so children with cerebral palsy are often unable to receive early diagnosis and intervention, which may affect their prognosis. An article about international expert consensus and recommendations on early identification and referral of cerebral palsy in community medical institutions was published in Development Medicine and Child Neurology in 2020. It proposed six clinical features that should prompt referral and two warning signs that warrant enhanced monitoring, as well as five recommendations for referral to medical experts and other healthcare professionals for the diagnosis of cerebral palsy. The recommendations may help primary child healthcare personnel in community medical institutions to early identify the children at high risk of cerebral palsy, thus reducing the delay of referral and intervention. This article gives an interpretation of the recommendations based on the actual situation in China, in order to improve the ability of primary child healthcare personnel in community medical institutions to early identify high-risk signals of cerebral palsy and conduct reasonable referral. This will help to achieve the early identification, early diagnosis, and early intervention to improve the prognosis of children with cerebral palsy.

关键词

脑瘫 / 转诊 / 社区医院 / 保健 / 解读 / 儿童

Key words

Cerebral palsy / Referral / Community hospital / Healthcare / Interpretation / Child

引用本文

导出引用
胡斌, 牟瑞, 唐婉秋, 王成举, 张雨平. 《国际专家建议:需立即转诊进行脑性瘫痪诊断评估的临床特征》解读[J]. 中国当代儿科杂志. 2021, 23(4): 328-331 https://doi.org/10.7499/j.issn.1008-8830.2012174
HU Bin, MOU Rui, TANG Wan-Qiu, WANG Cheng-Ju, ZHANG Yu-Ping. Interpretation of the international expert recommendations of clinical features to prompt referral for diagnostic assessment of cerebral palsy[J]. Chinese Journal of Contemporary Pediatrics. 2021, 23(4): 328-331 https://doi.org/10.7499/j.issn.1008-8830.2012174

参考文献

[1] Pagnozzi AM, Gal Y, Boyd RN, et al. The need for improved brain lesion segmentation techniques for children with cerebral palsy:a review[J]. Int J Dev Neurosci, 2015, 47(Pt B):229-246.
[2] Oskoui M, Joseph L, Dagenais L, et al. Prevalence of cerebral palsy in Quebec:alternative approaches[J]. Neuroepidemiology, 2013, 40(4):264-268.
[3] 胡斌, 王成举, 张雨平. 儿童脑性瘫痪超早期诊疗循证进展[J]. 国际儿科学杂志, 2019, 46(7):491-494.
[4] Boychuck Z, Andersen J, Bussières A, et al. International expert recommendations of clinical features to prompt referral for diagnostic assessment of cerebral palsy[J]. Dev Med Child Neurol, 2020, 62(1):89-96.
[5] 中华医学会儿科学分会康复学组. 2017年JAMA Pediatrics《脑性瘫痪早期精准诊断与早期干预治疗进展》中国专家解读[J]. 中国实用儿科杂志, 2018, 33(10):743-749.
[6] Novak I, Morgan C, Adde L, et al. Early, accurate diagnosis and early intervention in cerebral palsy:advances in diagnosis and treatment[J]. JAMA Pediatr, 2017, 171(9):897-907.
[7] Bennema AN, Schendelaar P, Seggers J, et al. Predictive value of general movements' quality in low-risk infants for minor neurological dysfunction and behavioural problems at preschool age[J]. Early Hum Dev, 2016, 94:19-24.
[8] Towsley K, Shevell MI, Dagenais L, et al. Population-based study of neuroimaging findings in children with cerebral palsy[J]. Eur J Paediatr Neurol, 2011, 15(1):29-35.
[9] Romeo DM, Ricci D, Brogna C, et al. Use of the Hammersmith infant neurological examination in infants with cerebral palsy:a critical review of the literature[J]. Dev Med Child Neurol, 2016, 58(3):240-245.
[10] Campbell SK. The Test of Infant Motor Performance[M]. Chicago:Infant Motor Performance Scales, LLC, 2012:3-10.
[11] 李彐峰, 余文, 戴燕琼, 等. Alberta婴儿运动量表指导治疗脑瘫高危儿的疗效观察[J]. 现代生物医学进展, 2019, 19(12):2287-2290.
[12] 王成举, 胡斌, 屈福祥, 等. 婴儿运动表现测试在早产儿运动评估中的应用[J]. 中国儿童保健杂志, 2020, 28(7):744-747.


PDF(1062 KB)
HTML

Accesses

Citation

Detail

段落导航
相关文章

/