Hu Bin, Mou Rui, Tang Wan-Qiu, Wang Cheng-Ju, Zhang Yu-Ping
Department of Pediatrics, Second Affiliated Hospital of Army Medical University, Chongqing 400037, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2021 Apr;23(4):328-331. doi: 10.7499/j.issn.1008-8830.2012174.
Under the guidance and support of national policies in recent years, the community medical system has been developed rapidly, among which primary child healthcare is carried out routinely in community hospitals, greatly alleviating the pressure of specialized pediatric hospitals and departments of pediatrics in secondary and tertiary general hospitals. However, due to the lack of professional training for primary child healthcare personnel in community medical institutions, early symptoms of children with cerebral palsy cannot be identified and so children with cerebral palsy are often unable to receive early diagnosis and intervention, which may affect their prognosis. An article about international expert consensus and recommendations on early identification and referral of cerebral palsy in community medical institutions was published in in 2020. It proposed six clinical features that should prompt referral and two warning signs that warrant enhanced monitoring, as well as five recommendations for referral to medical experts and other healthcare professionals for the diagnosis of cerebral palsy. The recommendations may help primary child healthcare personnel in community medical institutions to early identify the children at high risk of cerebral palsy, thus reducing the delay of referral and intervention. This article gives an interpretation of the recommendations based on the actual situation in China, in order to improve the ability of primary child healthcare personnel in community medical institutions to early identify high-risk signals of cerebral palsy and conduct reasonable referral. This will help to achieve the early identification, early diagnosis, and early intervention to improve the prognosis of children with cerebral palsy.
近年来,在国家政策的引导和支持下,社区医疗体系迅速发展,其中社区医院常规开展基层儿童保健工作,极大地缓解了专科医院及综合医院二、三级儿科的压力。然而,由于社区医疗机构基层儿童保健人员缺乏专业培训,脑瘫患儿的早期症状无法被识别,导致脑瘫患儿往往无法获得早期诊断和干预,这可能会影响其预后。2020年发表了一篇关于社区医疗机构脑瘫早期识别与转诊的国际专家共识和建议的文章。文章提出了六项应促使转诊的临床特征、两项需要加强监测的警示信号,以及五项关于转诊给医学专家和其他医疗专业人员以诊断脑瘫的建议。这些建议可能有助于社区医疗机构的基层儿童保健人员早期识别脑瘫高危儿童,从而减少转诊和干预的延迟。本文结合我国实际情况对这些建议进行解读,以提高社区医疗机构基层儿童保健人员早期识别脑瘫高危信号并进行合理转诊的能力。这将有助于实现早期识别、早期诊断和早期干预,以改善脑瘫患儿的预后。