在手术或干预关闭儿童中第二心房隔膜缺陷后的发育结果
K J Visconti1, D P Bichell, R A Jonas
1Department of Cardiac Surgery, Children's Hospital, Boston, MA 02115, USA.
Circulation
|November 24, 1999
概括
接受手术心脏修复的儿童的智商比那些接受设备关闭治疗的儿童更低. 需要进一步的研究来确认心肺绕道 (CPB) 是否会影响神经发育结果.
科学领域:
- 儿童心脏病学 儿童心脏病学
- 神经发育结果的结果
- 遗传性心脏病是一种先天性心脏病.
背景情况:
- 评估心肺绕道 (CPB) 对心脏手术后儿童发育的影响是具有挑战性的,因为缺乏对比组.
- 干预导管治疗为修复某些先天性心脏缺陷提供了一个非CPB替代方案.
- 本研究使用设备关闭作为与手术修复的比较,以评估CPB效应.
研究的目的:
- 为了比较患有通过手术修复的二次心房隔膜缺陷的儿童的神经发育结果,与跨导管装置关闭相比.
- 调查两组治疗组之间认知功能和成就的潜在差异.
- 探索心肺绕道 (CPB) 对发育轨迹的影响.
主要方法:
- 标准化神经心理测试对儿童进行了缺陷关闭后的测试.
- 研究了两个组:手术修复 (n=26) 和透导管装置关闭 (n=19).
- 用调整了测试年龄和父母智商的回归分析来比较结果.
主要成果:
- 与设备关闭相比,手术修复与全尺度智商 (-9.5分) 和性能智商 (-9.7分) 的显著缺陷有关.
- 区块设计子测试显示了组之间最显著的差异.
- 虽然大多数得分都处于正常范围内,但手术患者在特定的注意力测试中表现更好.
结论:
- 设备的关闭可能与较好的神经心理结果相关,而不是对二次心房隔膜缺陷的手术修复.
- 需要进一步的研究,包括潜在的随机试验,以证实这些发现.
- 该研究强调需要在发育评估中区分CPB效应和方法论文物.
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