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【目的】回顾性研究高危儿童早期全身运动评估(general movements assessment,GMs)及脑电图(electro-encephalogram,EEG)表现,分析GMs在脑瘫预测中的运用价值以及脑电图在高危儿中的应用价值。【方法】研究对象2011年12月31日满1周岁、且于复旦大学附属儿科医院康复中心进行随访的高危儿童,回顾性查找其出生后0～6月内GMs和EEG检查结果,同时具备两项检查的儿童纳入本研究。统计分析GMs对脑瘫的阳性预测值和阴性预测值、特异性和敏感性,不同发育结局儿童中EEG的比较。【结果】共纳入62例患儿,28例运动结局为脑瘫,11例为运动发育迟缓,23例为正常。GMs预测脑瘫敏感度96.4%,特异度73.9%,阳性预测值81.8%,阴性预测值94.4%;脑瘫儿童GMs异常率为96.4%,与运动发育迟缓儿童GMs异常率(63.6%)和运动发育正常儿童中GMs异常率(26.1%)差异有统计学意义。脑瘫及运动发育迟缓儿童EEG异常率分别为78.6%、81.8%,两者差异无统计学意义,但均高于运动发育正常儿童中EEG异常率(53.3%)(P<0.05);EEG异常主要表现为尖波、尖慢波发放,高电压及基本活动慢。【结论】GMs能有效地早期预测脑瘫,综合运用GMs、EEG能较全面反应患儿功能状况。
【Objective】 The purpose of this study was to retrospectively study the performance of general movement assessment (GMs) and electro-encephalogram (EEG) in high-risk children, analyze the value of GMs in the prediction of cerebral palsy, Value. 【Methods】 Subjects who were at least one year old on December 31, 2011 and were followed up at the Rehabilitation Center of Pediatric Hospital Affiliated to Fudan University were retrospectively reviewed for their GMs and EEG findings at 0 ~ 6 months after birth, Children with items examined included in this study. Statistical analysis of positive predictive value and negative predictive value, specificity and sensitivity of GMs for cerebral palsy, and comparison of EEG in children with different developmental outcomes. 【Results】 A total of 62 children were enrolled. 28 cases had cerebral palsy, 11 cases had motor retardation, and 23 cases were normal. GMs predicted cerebral palsy sensitivity 96.4%, specificity 73.9%, positive predictive value 81.8%, negative predictive value 94.4%; abnormal rate of GMs in children with cerebral palsy was 96.4%, abnormal GMs rate in children with stunting (63.6%) and normal motor development The abnormal rate of GMs in children (26.1%) was significantly different. The abnormal rates of EEG in children with cerebral palsy and motor retardation were 78.6% and 81.8% respectively, but there was no significant difference between the two groups (all P <0.05). EEG abnormalities were mainly The performance of sharp waves, sharp wave slow release, high voltage and slow basic activities. 【Conclusion】 GMs can effectively predict cerebral palsy in the early stage. Combined with GMs, EEG can fully reflect the functional status of children.