physical growth and assessement儿科七年制 带中文.ppt

SH/H=40.8÷62.5=0.65 0.650.63 Disproportionate Abnormal Example-Jack Jack was 12months of age and was 62.5cm in length At birth 1y 2y 6y 10y 14y SH/H 0.67 0.63 0.61 0.56 0.54 0.53 achondroplasia软骨发育不全 and 40.8cm in crown-rump length Assessment of growth 1. Growth level ( W/A,H/A, H.C./A) 2. Growth velocity (△W, △H, △HC) 3. Proportion of body Weight by stature( W/L, BMI)-not ratio Trunk-leg ratio (SH/H)- ratio On the BMI-for-age chart, find Sam’s age on the horizontal axis and visually draw a vertical line up from that point, then find his BMI on the vertical axis and visually draw a horizontal line across from that point. The point where the two intersect represents Sam’s BMI-for-age. When plotted on the growth chart, Sam’s BMI-for-age falls just below the 25th percentile curve. Percentile indicates the rank of a measure in a group of 100. This means that of 100 children the same sex and age as Sam, fewer than 25 children will have a BMI lower than his. Sam is neither overweight, underweight nor at risk of overweight. When a child’s plotted measurement falls between the 5th and 95th percentiles it is considered to be in the normal range. Sam’s BMI-for-age is in the normal range. When a child’s percentile rank falls outside the normal range (i.e., outside the 5th or 95th percentiles), further evaluation is needed. WHY ASSESS GROWTH? ??Best general index of health and nutritional status of an individual child and a population. ??A form of screening for growth disorders or health concerns related to growth. ??Regular serial measurements-early detection of malnutrition, neglect/abuse, or ill health. ??Determine adequate nourishment. GROWTH INDICES Recumbent length (birth to 36 months) or standing height. Weight. Head circumference (birth to 36 months). Crown-rump length or sitting height GROWTH REFERENCE/STANDARDS CDC(2000) WHO(2006) National references physical growth indices of 9