CAJ | 학술논문

目的研究全身运动评估(general movements assessment,GMs)、头颅CT、脑干诱发电位在高危儿脑发育评估中的运用价值.方法 32例高危儿根据月龄分为1月龄组(n=19)、3月龄组(n=13)进行GMs、头颅CT、脑干诱发电位检查,根据高危儿的临床表现结合病史和体格检查,不同月龄组又分为对照组和治疗组.结果 1月龄的治疗组额叶、颞叶、枕叶、顶叶CT值(18.27±2.72、19.91±3.15、19.45±3.48、17.18±2.89)与对照组的(23.27±2.49、22.36±1.50、23.18±2.86、21.09±2.98)比较差异有统计学意义(P＜0.05).3月龄的治疗组额叶、颞叶、枕叶、顶叶CT值(20.11±4.51、21.78±3.70、21.00±5.39、18.44±4.33)与对照组的(25.11±1.17、26.11±2.32、26.89±1.05、26.11±1.83)比较差异有统计学意义(P＜0 01).用GMs方法评估治疗组的高危儿均异常,评估对照组的高危儿均正常.脑干听觉诱发电位Ⅲ波潜伏期治疗组[1月龄组左(4.531±0.204) ms,右(4.540±0.202) ms；3月龄组:左(4.460±0.206) ms；右(4.547±0.240) ms]与对照组[1月龄组:左(4.380±0.033) ms,右(4.400±0.120) ms;3月龄组:左(4.570±0.165) ms；右(4.454±0.140)ms]之间差异无统计学意义,而V波潜伏期治疗组:[1月龄组:左(7.177±0.769) ms,右(7.142±0.646) ms；3月龄组:左(6.859±0.290) ms；右(6.876±0.313) ms]与对照组[1月龄组:左(6.626±0.183) ms,右(6.611±0.052) ms；3月龄组:左(6.596±0.291) ms；右(6.594±0.092) ms]之间差异有统计学意义.结论在脑干听觉诱发电位评估高危儿脑发育不确定时,可采用GMs和头颅CT,GMs和头颅CT有很高的一致性.运用GMs评估高危儿的脑发育更全面准确,且经济,可以反复检查,还可预测该高危儿的发育结局.
목적 연구전신운동평고(general movements assessment,GMs)、두로CT、뇌간유발전위재고위인뇌발육평고중적운용개치.방법 32례고위인근거월령분위1월령조(n=19)、3월령조(n=13)진행GMs、두로CT、뇌간유발전위검사,근거고위인적림상표현결합병사화체격검사,불동월령조우분위대조조화치료조.결과 1월령적치료조액협、섭협、침협、정협CT치(18.27±2.72、19.91±3.15、19.45±3.48、17.18±2.89)여대조조적(23.27±2.49、22.36±1.50、23.18±2.86、21.09±2.98)비교차이유통계학의의(P＜0.05).3월령적치료조액협、섭협、침협、정협CT치(20.11±4.51、21.78±3.70、21.00±5.39、18.44±4.33)여대조조적(25.11±1.17、26.11±2.32、26.89±1.05、26.11±1.83)비교차이유통계학의의(P＜0 01).용GMs방법평고치료조적고위인균이상,평고대조조적고위인균정상.뇌간은각유발전위Ⅲ파잠복기치료조[1월령조좌(4.531±0.204) ms,우(4.540±0.202) ms；3월령조:좌(4.460±0.206) ms；우(4.547±0.240) ms]여대조조[1월령조:좌(4.380±0.033) ms,우(4.400±0.120) ms;3월령조:좌(4.570±0.165) ms；우(4.454±0.140)ms]지간차이무통계학의의,이V파잠복기치료조:[1월령조:좌(7.177±0.769) ms,우(7.142±0.646) ms；3월령조:좌(6.859±0.290) ms；우(6.876±0.313) ms]여대조조[1월령조:좌(6.626±0.183) ms,우(6.611±0.052) ms；3월령조:좌(6.596±0.291) ms；우(6.594±0.092) ms]지간차이유통계학의의.결론 재뇌간은각유발전위평고고위인뇌발육불학정시,가채용GMs화두로CT,GMs화두로CT유흔고적일치성.운용GMs평고고위인적뇌발육경전면준학,차경제,가이반복검사,환가예측해고위인적발육결국.
Objective Investigate the applying value of general movements assessment(GMs),head CT and brainstem auditory evoked potential (BAEP) in high risk infants' brain development assessment.Methods 32 high risk infants follow in rehabilitation department were divided into 1-month-old group(n=19) and 3-month-old group(n=13).They were accepted the head CT and brainstem auditory evoked potential.They were divided into control group and the treatment group according to history,clinical manifestations and physical examination.Results 1-month-old of treatment group,CT values of frontal lobe,temporal lobe,occipital lobe,parietal lobe (18.27±2.72,19.91±3.15,19.45±3.48,17.18±2.89) compared with control group (23.27-±2.49,22.36 -± 1.50,23.18±2.86,21.09±2.98) had significant difference (P＜0.05).3-month-old of treatment group,CT values of frontal lobe,temporal lobe,occipital lobe,parietal lobe (20.11±4.51,21.78±3.70,21.00±5.39,18.44±4.33) compared with control group (25.11 ± 1.17,26.11 ± 2.32,26.89 ± 1.05,26.11 ± 1.83) (P＜ 0.01).The high-risk children in the treatment group with GMs methods to assess were abnormal,the high-risk children in the control group were normal.In the [atencies of Ⅲ wave of brainstem auditory evoked potential,treatment group (1-month-old group,left: (4.531 ±0.204) ms,right: (4.540± 0.202) ms ; 3-month-old group left: (4.460± 0.206) ms ; right: (4.547 ±0.240) ms and control group (1-month-old group: left (4.380± 0.033) ms,right: (4.400± 0.120) ms ; 3-month-old group: left (4.570±0.165) ms ; right (4.454±0.140) ms had no significant difference.In the latency of V wave,treatment group (1-month-old group: left (7.177±0.769) ms,right (7.142±0.646) ms ; 3-month-old group:left (6.859±0.290)ms;right(6.876±0.313) ms and control group (1-month-old group:left(6.626±0.183)ms,right(6.611± 0.052) ms ; 3-month-old group: left (6.596± 0.291) ms ; right (6.594± 0.092) ms) had significant difference (left: t =3.204,P＜0.05,right: t=2.776,P＜0.05).Conclusions When the brainstem auditory evoked potentials in high risk infants' brain development assessment was uncertain,GMs and head CT can be used.GMs assessment can be used in high risk infants' brain development to give a reliable,valid,comprehensive and accurate results,also predicted that the high risk infant's developmental outcomes.