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中华妇幼临床医学杂志(电子版) ›› 2015, Vol. 11 ›› Issue (4) : 502 -506. doi: 10.3877/cma.j.issn.1673-5250.2015.04.014

所属专题: 文献

论著

0~6岁孤立性侧脑室扩张患儿的丹佛发育筛查结果分析
张凡勇, 朱梁喜*(), 王艳萍, 满冬梅, 田丽娟, 林鹏   
  1. 272000 济宁医学院附属医院
  • 收稿日期:2015-06-05 修回日期:2015-06-25 出版日期:2015-08-01
  • 通信作者: 朱梁喜

Analysis of 0-6 year-old children with isolated ventriculomegaly by Denver development screening test

Fanyong Zhang, Liangxi Zhu*(), Yanping Wang, Dongmei Man, Lijuan Tian, Peng Lin   

  1. Department of Obstetrics, Affiliated Hospital of Jining Medical College, Jining 272000, Shandong Province, China
  • Received:2015-06-05 Revised:2015-06-25 Published:2015-08-01
  • Corresponding author: Liangxi Zhu
引用本文:

张凡勇, 朱梁喜, 王艳萍, 满冬梅, 田丽娟, 林鹏. 0~6岁孤立性侧脑室扩张患儿的丹佛发育筛查结果分析[J]. 中华妇幼临床医学杂志(电子版), 2015, 11(4): 502-506.

Fanyong Zhang, Liangxi Zhu, Yanping Wang, Dongmei Man, Lijuan Tian, Peng Lin. Analysis of 0-6 year-old children with isolated ventriculomegaly by Denver development screening test[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2015, 11(4): 502-506.

目的

通过丹佛发育筛查(DDST)分析不同程度及宫内转归类型的孤立性侧脑室扩张(IV)患儿生后0~6岁的智能发育情况。

方法

选择2007年1月1日至2013年1月1日于济宁医学院附属医院就诊的186例IV患儿为研究对象,并纳入研究组(n=186),再根据IV诊断标准将其进一步分为轻度扩张型IV亚组(n=159)、中度扩张型IV亚组(n=18)和重度扩张型IV亚组(n=9)。选择同期于本院行常规体检的200例正常婴幼儿为对照组(n=200)。两组儿童在排除影响发育的高危因素后,均进行DDST,将不同程度及宫内转归类型的研究组患儿分别与对照组儿童进行比较,并研究DDST结果可疑或异常发生率与患儿年龄的关系。

结果

①研究组DDST结果示异常和可疑的患儿分别为8例(4.3%)和16例(8.6%),对照组分别为0和4例(0.2%),两组比较,差异有统计学意义(χ2=95.69,P<0.05)。②轻度扩张IV亚组的进展型、中度扩张IV亚组的进展型和稳定型、重度扩张IV亚组的3种类型患儿DDST结果分别与对照组比较,差异均有统计学意义(χ2=15.99,20.61,35.16, 27.56, 14.41,9.35;P<0.05)。③研究组DDST结果示异常和可疑发生率与患儿年龄增加呈正相关关系(χ2=154.30, 159.09;P<0.05)。④研究组DDST结果示异常及可疑的24例患儿中,智能发育障碍表现依次为言语障碍(54.2%)、粗大运动发育障碍(41.6%)、精细动作发育障碍(33.3%)和个人与社会(16.7%)。

结论

轻度扩张IV的进展型、中度扩张IV的进展型和稳定型、重度扩张IV的3种类型均可能导致IV患儿智能发育障碍,并且患儿智能发育障碍发生率可随其年龄增加而增高。对于早期未发现异常的IV高危儿应重视远期随访,尤其注意其言语和运动能发育情况。

Objective

To investigate the intelligential development of 0-6 year-old children with different degrees and prognosis of isolated ventriculomegaly(IV) by Denver development screening test (DDST).

Methods

From 1st January 2007 to 1st January 2013, a total of 186 children with IV were selected as research group(n=186) in Affiliated Hospital of Jining Medical College. According to IV diagnostic criteria, they were further divided into mild IV subgroup (n=159), moderate IV subgroup (n=18) and severe IV subgroup (n=9).Meanwhile 200 normal children at the same hospital were chosen as the control group(n=200). The DDST results were compared between every subgroup and control group, respectively. And the relationship between abnormal and suspicious DDST results of children with IV and their age were observed.

Results

①The DDST results showed that there were 8 abnormal cases (4.3%) and 16 suspicious cases (8.6%) in research group, 0 abnormal case and 4 suspicious cases (0.2%) in control group, and the difference had statistical significance between two groups(χ2=95.69, P<0.05).②The results of progressive type of mild IV subgroup, progressive and stable types of moderate IV subgroup and the three types of severe IV subgroup were respectively compared with the control group and all the differences were significant (χ2=15.99, 20.61, 35.16, 27.56, 14.41, 9.35; P<0.05). ③The incidence rates of abnormal and suspicious DDST results in research group were significantly correlated with their age(χ2=154.30, 159.09; P<0.05). ④ The intelligent developmental disorders of 24 children with abnormal and suspicious DDST results were as follow: speech disorder (54.2%), large motor development disorder (41.6%), fine movement disorder (33.3%) and personal and social disorder (16.7%).

Conclusions

The progressive type of mild IV, progressive and stable types of moderate dilatation, three types of severe dilatation, can lead to mental retardation. The proportion of mental retardation increases along with IV patients' age. Infants with high risk who are not found abnormal early need long-term follow-up, especially in the aspect of words and movement ability.

表1 两组DDST结果比较[例数(%)]
表2 轻度扩张型IV亚组各类型DDST结果与对照组比较[例数(%)]
表3 中度扩张型IV亚组各类型DDST结果与对照组比较[例数(%)]
表4 重度扩张型IV亚组各类型DDST结果与对照组比较[例数(%)]
表5 DDST结果异常及可疑的患儿与年龄的关系[例数(%)]
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