不同类型形态性头颅畸形婴幼儿的神经心理发育特征  

Characteristics of neuropsychological development in infants with different types of morphological cranial malformation

作　　者：张晚霞 杨晨璐 钱月[1] 王颖[1] 梁爱民[1] ZHANG Wanxia;YANG Chenlu;QIAN Yue;WANG Ying;LIANG Aimin(Department of Health Care,Beijing Children's Hospital,Capital Medical University,National Center for Children's Health,Beijing 100045,China)

机构地区：[1]国家儿童医学中心,首都医科大学附属北京儿童医院保健中心,北京市100045

出　　处：《中国康复理论与实践》2023年第5期570-575,共6页Chinese Journal of Rehabilitation Theory and Practice

摘　　要：目的比较不同类型形态性头颅畸形婴幼儿的神经心理发育状况。方法2020年1月至2021年8月,选择在北京儿童医院体检门诊接受颅型测量和0-6岁儿童神经心理发育量表测量的0~18月龄儿童954例,依据颅型测量结果分为短头组、斜头组、不对称短头组、舟状头组和正常组,并根据0~6岁儿童神经心理发育量表计算发育商(DQ)。结果头颅正常组449例,短头组94例,斜头组201例,不对称短头组82例,舟状头组128例。其中,短头组大运动能区“发育边缘和发育迟缓”(DQ<85)检出率最高(60.6%),不对称短头组精细动作(64.6%)、语言(45.1%)、适应性(51.2%)和社会行为能区(48.8%)“发育边缘和发育迟缓”检出率最高。5组间除语言能区外,其他4个能区DQ均有非常高度显著性差异(F>14.835,P<0.001);与正常组比较,除舟状头组外,其余3组4个能区DQ下降(P<0.05);斜头组大运动、精细动作和适应性能区DQ高于不对称短头组(P<0.05),斜头组大运动和精细动作能区DQ高于短头组(P<0.05)。线性回归分析显示,DQ与头部比率和头颅不对称指数负相关(|B|>0.967,P<0.05)。结论4种头颅畸形中,舟状头发育水平接近正常,短头、斜头和不对称短头在婴幼儿期有不同程度发育落后,主要表现在大运动、精细动作、适应性和社交行为方面。头颅畸形越重,各能区发育落后风险越大。Objective To compare the neuropsychological development of infants with different types of morphologic cranial deformities.Methods A total of 954 children aged 0 to 18 months who came to Beijing Children's Hospital from January,2020 to August,2021 for cranial measurement and neuropsychological development measurement were selected.They were divided into brachycephaly group,plagiocephaly group,asymmetric brachycephaly group,scaphocephaly group and normal group according to the cranial measurement.The development quotient(DQ)was calculated from Children Neuropsychological Development Scale(0-6).Results There were 449 cases in the normal group,94 cases in the brachycephaly group,201 cases in the plagiocephaly group,82 cases in the asymmetric brachycephaly group and 128 cases in the scaphocephaly group.The detection rate of Developmental Edge and Delay(DQ<85)for gross motor area was the most in brachycephaly group(60.6%),and it was the most for fine motor(64.6%),language(45.1%),adaption(51.2%)and social behavior areas(48.8%)in the asymmetrical brachycephaly group.The DQ was different among the five groups for all the areas except the language area(F>14.835,P<0.001);compared with the normal group,DQ decreased for all the four areas in all the groups except the scaphocephaly group;DQ of the areas of gross motor,fine motor and adaption was more in the plagiocephaly group than in the asymmetric brachycephaly group(P<0.05),while DQ of the areas of gross motor and fine motor was more in the plagiocephaly group than in the brachycephaly group(P<0.05).Linear regression analysis showed that,DQ negative linear correlated with the cephalic ratio and cranial vault asymmetry index(|B|>0.967,P<0.05).Conclusion Among four kinds of cranial malformation in infants,the neuropsychological development of the scaphocephaly group is almost normal,and somehow delays for brachycephaly,plagiocephaly and asymmetric brachycephaly,especially in the aspects of gross motor,fine motor,adaption and social behavior.The more serious the cranial defor

关 键 词：头颅畸形 神经心理发育 发育迟缓 婴幼儿 

分 类 号：R682.1[医药卫生—骨科学]