Neurological evaluation of the maturity of newborn infants.
Neurological evaluation of the maturity of newborn infants.
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新生儿成熟度的神经学评估。
DOI：
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发表时间：
1968
影响因子：
5.2
通讯作者：
C. Amiel‐Tison
中科院分区：
文献类型：
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作者：
C. Amiel‐Tison
在胎儿生命的最后三个月，大脑的成熟导致肌肉张力和某些反射的不断变化。这使得能够设计一个计划，从而可以评估不同年龄的早产儿的神经成熟度。Saint-Anne Dargeal（1955）通过分析一组100例已知胎龄的早产儿，以及胎龄28周出生并研究至胎龄40周的健康早产儿的纵向演变，定义了这种神经系统进展。临床结果与脑电图（Dreyfus-Brisac，Flescher和Plassart，1962）和脑发育的解剖学（Larroche，1962）阶段进行了比较。在将这一成熟方案应用于“小的日期”婴儿时，已经得出结论，胎儿生命期间的大脑发育独立于不利的妊娠环境。慢性胎儿应激主要反映在出生体重上，出生时的身长在较小程度上。然而，从解剖学和生理学的角度来看，大脑的进化与胎龄成正比（Gesell和Amatruda，1945; Bergstrom，Gunther，Olow和Soderling，1955; Saint-Anne Darglane，1955）。本文所依据的原始观察结果是闵可夫斯基、拉罗什、维格诺、德雷福斯-布里萨克和圣安妮·达根（1966）的观察结果。本文提出了一种实用的方法，临床应用这些作者所描述的原则。Butler和博纳姆（1963）估计，三分之一的婴儿体重低于2500克。胎龄大于38周。早产儿在出生后不久就容易发生严重的代谢紊乱，因此，必须及早对胎龄进行评估。有时候，成熟的最初神经学评估会被神经系统疾病的体征所混淆。但是，一般来说，在生命的最初几天进行神经系统检查可以提供
Cerebral maturation during the last three months of fetal life brings about constant modification of muscle tone and of certain reflexes. This has enabled a scheme to be devised, whereby the neurological maturity of the premature infant at different ages can be assessed. Saint-Anne Dargassies (1955) defined this neurological progression by analysing a group of 100 prematures of known gestational age, and the longitudinal evolution of healthy prematures, born at 28 weeks' gestational age and studied up to 40 weeks' gestational age. The clinical results have been compared with the electroencephalographic (Dreyfus-Brisac, Flescher, and Plassart, 1962) and anatomical (Larroche, 1962) stages of development of the brain. In applying this maturation scheme to 'small-for-dates' babies it has been concluded that brain development during fetal life progresses independently of unfavourable gestational circumstances. Chronic fetal stress is reflected mainly in the birthweight and to a lesser degree in the body length at birth. The brain, however, from the point of view of anatomy and physiology, evolves more in proportion to the gestational age (Gesell and Amatruda, 1945; Bergstrom, Gunther, Olow, and Soderling, 1955; Saint-Anne Dargassies, 1955). The original observations on which this paper is based are those of Minkowski, Larroche, Vignaud, Dreyfus-Brisac, and Saint-Anne Dargassies (1966). This paper presents a practical method for applying clinically the principles described by these authors. Butler and Bonham (1963) estimated that a third of infants weighing less than 2500 g. have a gestational age greater than 38 weeks. The small-for-dates baby is liable to develop serious metabolic disturbance shortly after birth; for this reason it is imperative that the assessment of gestational age be made early. Occasionally the initial neurological evaluation of maturation is confused by signs of neurological disorders. But, as a rule, neurological examination during the first days of life can provide