神经心理测验与Vojta姿势反射的应用分析

Application analysis of neuropsychological test and Vojta posture reflex

目的对小儿神经心理测验与Vojta姿势反射检查在2—6月龄婴儿中的应用效果进行对比分析。方法对2008年5月至2010年5月在乌鲁木齐市妇幼保健院儿保门诊进行健康体检的1497例2～6月龄婴儿进行神经心理测验及Vojta姿势反射检查，并对早期发现的脑损伤可疑儿进行指导与干预。结果小儿神经心理测验各月龄发育异常检出率降序排列最高前3位分布在2、6、3月龄，Vojta姿势反射则分布在2、3、6月龄，各月龄组儿心量表和Vojta姿势反射阳性率差异有统计学意义（Х^2值分别为11．34、110．54，均P〈0．05）。两种方法的检测结果有差别，Vojta姿势反射的阳性率较高（Х^2=428．05，P〈0．05）。结论小儿神经心理测验与Vojta姿势反射均能客观反应小儿的神经系统发育水平，但在生命早期判断较为困难，处置原则应根据月龄及可疑程度区别对待。Vojta姿势反射的阳性率高于小儿神经心理测验，建议将小儿神经心理测验与Vojta姿势反射列为2—6月龄婴儿常规健康体检范围，提高脑损伤儿筛查的阳性率，避免漏检与误诊。

Objective To compare and analyze the application of neuropsychological test and Vojta posture reflex in examining infants of 2- 6 months. Methods From May 2008 to May 2010 1 497 infants of 2-6 months receiving physical examination in Child Health Clinic of Urumqi MCH underwent neuropsychological teStS and Vojta posture reflex examination, and guidance and intervention were given to ones suspected with brain injury detected at early stage. Results The top three of developmental abnormality rates detected with neuropsychological test were at 2-, 6- and 3-month age, while Vojta posture reflex were at 2-, 3- and 6-month age. There were statistical differences in heart scale and positive rate of Vojta posture reflex among different groups （X2 value was 11.34 and 110.54, respectively, both P 〈 0.05 ）. The detection results of two methods were different, and the positive rate of Vojta posture reflex was higher （X^2 = 428.05, P 〈 0.05 ）. Conclusion Both neuropsychological test and Vojta posture reflex can reflect the development level of nervous system, but it is difficult to determine at early stage. Disposal should be based on age and suspicious degree. The positive rate of Vojta posture reflex is higher than that of neuropsychological test, so it is suggested to take both methods in routine healthy physical examination for 2- to 6-month infants to improve the screening of infants with brain injury and avoid undetected cases or misdiagnosis.