2013-2015年北京市儿童发育迟缓社区筛查结果分析

Analysis on community screening results of children with developmental delay in Beijing from 2013 to 2015

目的探讨目前北京市使用的两种针对儿童发育迟缓的筛查方法 (丹佛发育筛查法和预警征)在确诊率方面的差异及各自的优势并分析目前发育迟缓儿童的基本情况。方法对2013-2015年1 139例转诊儿童进行丹佛发育筛查法和预警征法两种筛查方法及诊断结果的对照分析。结果两种筛查方法转诊儿童确诊率差异无统计学意义(P>0.05),经诊断为轻度及以下发育迟缓率预警征组81.1%高于丹佛发育筛查法组的74.7%,差异有统计学意义(P<0.05)。在确诊发育迟缓儿童中经诊断轻度发育迟缓儿童占比大,发育迟缓儿童男女比例为1.85∶1。结论预警征简便、易培训且耗时短,可以作为有力的筛查工具。筛查过程中遇到有明显低于该儿童年龄段水平的个别表现,虽然整体判断该儿童处于正常发育水平,但仍需转诊以免漏诊。

Objective To explore the two kinds of screening methods（ Denver development screening test and early warning sign） used for the children with developmental delay in Beijing,investigate the differences between the two methods in diagnosis and their respective advantages,analyze the basic situations of developmental delay children. Methods A comparative analysis of these two kinds screening methods and diagnostic results of 1 139 children with developmental delay from 2013 to 2015 was performed. Results These two screening methods for transferred children with developmental delay had no difference in diagnostic rate（ P〉0. 05）. Diagnostic rate in warning sign group was 81. 1%,which was higher than that in Denver development screening test group（ 74. 7%） among the referral children who were diagnosed as mild developmental delay（ P〈0. 05）. Among these children who were diagnosed as developmental delay,mostly were mild,and the ratio of boys and girls with developmental delay was 1. 85 ∶ 1. Conclusion Early warning sign is simple,easy to train and short time consuming,so it can be used as a powerful screening tool. In the screening process,there was some children＇s behavior which was obviously lower than the age level of these children,although the synthetic judgment showed these children are at normal development level,transfer treatment is still needed to avoid missed diagnosis.