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脑瘫高危婴儿的早期识别:在新西兰一家三级新生儿病房的常规临床实践中发展通用运动评估的应用

Early identification of infants at risk of cerebral palsy: developing the use of general movement assessment in routine clinical practice in a tertiary neonatal unit in New Zealand.

作者信息

Sandle Meghan, Sheppard Alison, Fletcher Angelica Allermo, Berry Max, DeVries Nathalie

机构信息

Paediatric Registrar, Capital and Coast DHB, Wellington; MSc student, Paediatrics and Child Health, University of Otago, Wellington.

Neurodevelopmental Physiotherapist, Capital and Coast DHB, Wellington.

出版信息

N Z Med J. 2020 May 8;133(1514):63-70.

Abstract

BACKGROUND

Preterm infants have a high risk of neurodevelopmental disability, including cerebral palsy (CP). Often, CP is not diagnosed until after 12 months, leading to delay in targeted interventions. The General Movements assessment (GM) evaluates the spontaneous movements of high-risk infants from birth to 20 weeks corrected postnatal age (CPA), and accurately predicts the risk of CP. This allows for earlier diagnosis and intervention, potentially changing the trajectory of disability, yet routine use of GM is not well established in New Zealand.

AIM

To describe the process of setting up GM in a tertiary neonatal unit.

METHODS

We reviewed the process and progress made to date setting up GM in our service.

RESULTS

Challenges and potential solutions for the implementation of GM were identified. Key areas of development included staff training and support, IT services, resources, medical documentation, inter-departmental communication and establishing clinical pathways.

CONCLUSION

GM has become successfully integrated into the assessment of high-risk infants in our neonatal unit, with the aim to provide valuable information to health professionals and families to optimise intervention and improve outcomes. Efforts will continue to ensure there is robust and sustainable system for using GM in our service.

摘要

背景

早产儿患神经发育障碍(包括脑瘫)的风险很高。通常,脑瘫直到12个月后才被诊断出来,导致针对性干预延迟。全身运动评估(GM)可评估高危婴儿从出生到出生后20周矫正胎龄(CPA)的自发运动,并准确预测脑瘫风险。这使得能够更早地进行诊断和干预,有可能改变残疾的发展轨迹,但GM在新西兰尚未得到广泛常规应用。

目的

描述在一家三级新生儿病房建立GM评估的过程。

方法

我们回顾了在我们的服务中建立GM评估至今的过程和进展。

结果

确定了实施GM评估的挑战和潜在解决方案。关键发展领域包括员工培训与支持、信息技术服务、资源、医疗文档、部门间沟通以及建立临床路径。

结论

GM评估已成功融入我们新生儿病房对高危婴儿的评估中,旨在为健康专业人员和家庭提供有价值的信息,以优化干预并改善结果。我们将继续努力,确保在我们的服务中有一个强大且可持续的GM评估应用体系。

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