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.
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