1岁内36项神经运动检查在脑瘫早期诊断中的应用

Effect of 36 item neuro-motor examination on early diagnosis of children with cerebral palsy within 1 year-old

目的评价 1岁内 3 6项神经运动检查在小儿脑瘫早期诊断中的作用。方法对 2 10例 2— 12个月脑瘫患儿 3 6项神经运动检查结果进行分析。结果脑瘫儿中可检出 4— 2 9项反映反射、肌张力、姿势、运动异常的项目。其中 2— 6个月组 ,4个方面的异常项目按出现多少分别排列为 :①反射异常 :膝反射、手持握反射、巴氏征、非对称性颈肢反射、踝阵挛、坐位平衡反应、踏步反射、交叉伸展反射、紧张性迷路反射、躯干侧弯反射、拥抱反射 ;②姿势异常 :仰卧翻成侧卧头后仰≥ 15°、立位悬垂、平卧颈后空隙≥1cm、俯卧悬垂、侧位悬垂、拉起、紧张性头偏斜、自发姿势异常 ;③肌张力异常 :足背屈角、上肢围颈、手握拳、扶立足跟抬起≥ 3 0°、拇指交叉达掌心、窝角、内收角、跟耳角 ;④其他异常 :头围≤ x -2s、斜视、主动运动减少 /异常、听觉异常、视觉异常、眼颤、癫痫。结论 1岁内 3 6项神经运动检查有助于脑瘫早期诊断。

Objective To evaluate the effect of 36-neuro-motorial examination on early diagnosis of children with cerebral palsy within 1 year-old.Methods36-neuro-motorial examination was analysed in 210 children with cerebral palsy from 2 to 12 months. Results4-29 items reflecting the abnormity of reflex, muscle tone, posture and motion were observeed in patients with cerebral palsy.If these abnormities were laid according as frequency among 2-6 months,reflex abnormities are knee tendon reflex, palmar grasp reflex,Babinski sign,asymmetrical tonic neck reflex,ankle clonus,sitting equilibrium reflex,stepping reflex,crossed extension reflex,tonic labyrinthine reflex,trunk incurvation reflex,Moro reflex; posture abnormities are head to back≥15°,from supine to the side position, axillar suspension reflex,posterior neck fovea≥1cm in the supine position,landau reflex,Vojta reflex,traction reflex,tonic torticollis,abnormal spontaneous posture;muscle tone abnormities are foot dorsiflexion angle,scarf sign,tonic palmar grasp,to up the foot heel≥30° in the stand position,thumb decussation to the palm,poples angle,adductor angle,heel-ear angle; others are head cycle≤-2s, squint, active movement attenuation or abnormity, auditory abnormity, visual abnormity, ophthalmodonesis, epilepsy.Conclusions 36-neuro-motorial examination is effective for early diagnosis of cerebral palsy within 1 year.