婴儿体位性颅型异常的早期筛查及保健护理

Early screening and health care of postural cranial abnormalities in infants

目的 建立婴儿体位性颅型异常早期筛查和分级管理的儿童保健护理模式。方法 按照研究纳入标准和排除标准,选取2019年2月至2020年3月在儿童保健门诊常规查体的健康婴儿作为横断面回顾性研究。接受培训的保健护士对初筛高风险婴儿按流程转诊,所有转诊婴儿接受美国SmartSoc3D光学扫描数据采集系统,获取婴儿头部形状的全面数据,并根据美国儿科指南CHOA分级参考标准做出诊断和分度。统计方法以计数资料计算例数和构成比[例数(%)]。结果 保健护士共筛出591例颅型异常高风险婴儿,诊断颅型异常婴儿346例,占比58.54%,异常筛查比例最高在0~4月龄,占60.96%,分型以斜头和短头为主,87.86%为轻度,6.07%为中、重度颅型异常。58.09%纳入一级管理,23.12%纳入二级管理,18.79%纳入三级管理。结论 保健护士对婴儿体位性颅型异常早期筛查具有较好的可靠性,有利于在不增加医患负担的情况下提高早期识别率,建立婴儿体位性颅型异常早期筛查和分级管理的保健护理模式可以提高婴儿体位性颅型异常的预后。

Objective To establish the nurse-guide care model for early screening and grading management of infant postural cranial abnormalities.Methods According to the inclusion and exclusion criteria of the study,healthy infants in children's health care clinics from February 2019 to March 2020 were included in this cross-sectional retrospective study.High-risk infants were referred according to our protocol.All referred infants received examination using the SmartSoc 3D optical scanning data collection system(United States),then were diagnosed and graded according to the CHOA grading reference standard in the American Pediatric Guidelines.Statistical methods use counting data to calculate the number of cases and the constituent ratio(n,%).Results Totally 591 high-risk infants with cranial abnormalities were screened by health nurses,and 346 infants with cranial abnormalities were diagnosed,accounting for 58.54%.The highest proportion of abnormal screening was 0-4 months old,accounting for 60.96%.The main types were oblique head and short head,with 87.86% being mild and 6.07% being moderate to severe cranial abnormalities.Incorporate 58.09% of primary management,23.12% of secondary management,and 18.79% of tertiary management.Conclusion Health nurses have good reliability in early screening of infant postural cranial abnormalities,which is conducive to improving the early recognition rate without increasing the burden on doctors and patients.Establishing the nurse-guide care model for early screening and graded management of infant postural cranial abnormalities can improve the prognosis of infant postural cranial abnormalities.