Stieh J, Kramer H H, Harding P, Fischer G
Department of Pediatric Cardiology, Christian-Albrechts-University Kiel, Germany.
Neuropediatrics. 1999 Apr;30(2):77-82. doi: 10.1055/s-2007-973464.
Many factors may intervene with the motor development of children with congenital heart disease (CHD). Children aged 5 to 14 years with various CHD were examined for disturbances of gross and fine motor development using motometric tests and compared with 30 healthy controls. The results of the Körperkoordinationstest für Kinder (KTK) (a body coordination test for children) for gross motor development were significantly lower in patients with uncorrected cyanotic CHD (motor quotient MQ 74.8 +/- 11.7, mean +/- 1 standard deviation, n = 16) and after corrective surgery (MQ 81.2 +/- 16.6, n = 25) than in controls (MQ 102.8 +/- 11.8, n = 30). No relationship between these results and the cardiopulmonary exercise capacity was found. In patients with cyanotic CHD, significant deficits in fine motor development were present before corrective surgery (e.g. Zielpunktiertest [dotting] MQ 87.7 +/- 9.9 vs. 106.5 +/- 10.8), but already two years afterwards the results reached nearly normal values (MQ 97.1 +/- 17.0). In contrast, children with acyanotic CHD demonstrated normal gross and fine motor development. These results indicate that long-standing hypoxemia in infancy must be considered as an important cause of the pronounced motor disturbances. Early neurological evaluation of these children and a specialized motor physiotherapy are recommended.
许多因素可能会干预先天性心脏病（CHD）患儿的运动发育。对5至14岁患有各种CHD的儿童进行了运动测试，以检查其大运动和精细运动发育障碍，并与30名健康对照者进行比较。未矫正的青紫型CHD患者（运动商MQ 74.8 +/- 11.7，平均值 +/- 1个标准差，n = 16）和矫正手术后（MQ 81.2 +/- 16.6，n = 25）的儿童大运动发育的儿童身体协调性测试（KTK）结果明显低于对照组（MQ 102.8 +/- 11.8，n = 30）。未发现这些结果与心肺运动能力之间存在关联。在青紫型CHD患者中，矫正手术前精细运动发育存在明显缺陷（例如定点测试[点画] MQ 87.7 +/- 9.9 vs. 106.5 +/- 10.8），但两年后结果已接近正常值（MQ 97.1 +/- 17.0）。相比之下，非青紫型CHD患儿的大运动和精细运动发育正常。这些结果表明，婴儿期长期存在的低氧血症必须被视为明显运动障碍的重要原因。建议对这些儿童进行早期神经学评估和专门的运动物理治疗。
