儿科儿童生长发育PPT课件

儿童体格生长发育 . I. 年龄分期 II.生长发育的指标 III.影响生长发育的因素 Age Group 年龄分期 Human development progresses through a sequence of events,these landmarks should occur at approximately the same age.It is easier to grasp development by focusing on specific key age group. 儿童的生长发育既循序渐进又有阶段性， 某些里程碑式的事件应在某一年龄出现。 注意关键年龄段更易于把握生长规律。 The fetal period 胎儿期40周 The most dramatic events in growth and development occur before birth.The transformation of a single cell into an infant. 生长发育过程中最令人激动的事件发生在 出生前：单个细胞发育成胎儿。 Embryonic period:8wk The rudiments of all major organ systems have developed.weight:9g,length:5cm 胚胎期8周 各主要器官系统雏形初现。重 量：9克，长度：5厘米。 Fetal period:9-40wk Increase in cell number and size,structural remodeling of several organ systems.During the third trimester,weight triples and length doubles.Term weight:3250g,length:50cm. 胎儿期9-40周 细胞数量与体积增加，器官系统结构重组 ，孕晚期发育迅速：体重增加3倍，身长增加2倍。孕末期 体重平均3250克，身长50厘米。 The neonatal period 4wk新生儿期 Adaptation to extrauterine life requires rapid and profound physiologic changes,including aeration of the lungs,rerouting of the circulation,and activation of the intestinal tract.To obtain nourishment,to avoid hypothermia or hyperthermia,and to ensure safety,neonates must react appropriately to an expanded range of sensory stimuli. 适应宫外生活时，新生儿在生理上需要经历快速而深刻 的变化，包括肺泡扩张充气、循环径路改变、肠道功能激 活等。为了获取营养物质、避免体温过低或过高并保障安 全，新生儿需要对纷繁的外界刺激做出适当的反应。 A newborns weight may decrease 10% below birthweight in the 1st wk as a result of excretion of excess extravascular fluid and possibly poor intake.Infants should regain or exceed birthsweight by 2wk of age and should grow at approximately 30gday during the 1st month. 生后第一周，由于多余的细胞外液被排出体外及 摄入不足，新生儿的体重会比出生体重减少10 。生后两周时应恢复或超过出生体重，此后至 满月，体重每日增加30克左右。 Limb moves purposelessly,smiling occurs involuntarily,eye gazing,head turning,and sucking under conscious control. 新生儿有无目的的肢体运动、无意微笑， 可凝视及转头，会有意识地吸吮。 Basic trust develops as infants learn that their urgent needs are meet regularly.Infants does not consistently experience feeding as the pleasurable reduction of tension often show increased irritability and physiological instability(spitting,diarrhea,poor weight gain)as well as behavioral problem. 由于基本需求得到规律的满足，新生儿期会建立 基本信任感。饥饿时不能规律地体验到喂奶快乐 的婴儿，常显示烦躁不安和生理不适（呕吐，腹 泻，体重不增）及行为障碍。 The infant period婴儿期0-12月 Normal children follow a trajectory of increasing physical size and complexity of function. 婴儿期体格发育步入了快速增长的轨道， 各项功能也日趋复杂。 Weight gain(g/d) Growth in length(cm/mo) 0-3mo303.5 3-6mo202.0 6-9mo151.5 9-12mo121.2 12mo9kg75cm total 3m:lifts head 6m:sits alone for a short period 9m:stands alone 12m:walks independently The primary emotions of anger,joy,interest,fear,disgust,surprise,a nd tantrums appear,separations become difficult. 初级感情出现：表现生气、高兴、感兴趣、害 怕、讨厌、吃惊和发脾气等，与父母难以分离。 The toddler 幼儿期2-3岁 The growth rate slowers further in the 2nd year of life,then at a steady rate,weight gain:2kg/yr,length:5-7cm/yr. 第二年生长速度减慢，然后较为恒定，体重每年 增加2公斤，身高每年增加5-7厘米。 Walks alone,crawls up stairs,walks up and down stairs,run stiffly,then runs well,jumps and opens doors.18mo:10words;24mo:puts 3words together;36mo:known full name,age and sex,counts 3 objects,repeats 3numbers. 可以独自走动，上下楼梯、跑步跳跃、开门 等。18个月时会说10个单词；24个月会把3个 单词连在一起说；36个月时知道自己名字、年 龄、性别，会数3种物品，重复3个数字。 Preschool years学龄前期4-6岁 Gains 2kg in weight and 7cm in height per year. Throwing,catching,and kicking balls,riding on bicycles and dancing. Tower 9 cubes,imitates gate,copy cross,circle,and square. Language occurs most rapidly.Vocabulary increases from 50-100 words to more than 2000. 体重每年增加2公斤，身高每年增长7厘米。学会扔球、接球、踢球， 会骑车、跳舞。会垒9块积木，模拟垒门、画十字、圆圈和方块。语 言发展迅速，词汇量从50-100个单词增加都2000个以上。 Early School Years 学龄期6-12岁 Growth during the period averages 3-3.5kg and 6cm per year. Child is judged according their ability to produce socially valued outputs,such as good grades and home runs.Attention and receptive language affect each oyher as well as every other aspect of learning. 学龄期体重平均每年增加3-3.5公斤，身高增长6厘米。对 学龄期儿童的评价开始注重其社会化表现，如在学校的成 绩和家务劳动能力。注意力和语言能力互相影响并关系到 学习的其他方面。 Adolescence青春期12-20岁 Foster the transition from childhood to adulthood.Between the ages of 10 and 20yr,children undergo rapid changes in body size,shape,physiology,and psychologic and social functioning.Adolescence proceeds across three distinct periods:early,middle,and late.However,individual variation is substantial. 从儿童到成人的转型期。从10岁到20岁，儿童经历了身体上，生理 上、心理上，及社会角色的快速转变。此期又可分为早、中、晚三期 ，个体差异很大。 Physical growth indicators Growth assessment is an essential component of pediatric health surveillance because almost any problem within the physiologic,interpersonal,and social domains can adversely affect growth. Weight Useful Numbers and Formulas Age(mo/yr) Weight(Kg) At birth 3.30.4（boys） 3.20.4（girls） At 3mo 6 At 12mo 9 6mo 3+mo0.7 7-12mo 6+mo0.25 2-12yr Age(yr)2+8 Length/height Age(yr)Length/height(cm) At birth50 At 1yr75 At 2yr85 2-12yrAge(yr)7+75 Sitting height Sitting is the length of head to tuberosity.Body proportions follow a sequence of regular changes with development.Proportionality can be assessed by measuring the lower body segment,and the upper body segment.The ratio of upper body segmengt divided by lower body segment(U/L ratio)equals approximately 1.7 at birth,1.3 at 3yr,and 1.0 after age 7yr.Higher U/L ratio are characteristic of short-limb dwarfism or bone disorders such as rickets. Head circumference头围 Since the head circumference is eyebrow on the edge of the external occipital protuberance around the hightest point of maximum diameter of the first week. 新生儿的头围平均为34cm，1岁时平均为46cm,2 岁时48cm，5岁时约为53-54cm，与成人相近。 Chest circumference 胸围 Chest cir