早期儿童全身麻醉和注意力缺陷多动性障碍的风险
Mingyang Sun1, Wan-Ming Chen2,3, Saihao Fu1
1Department of Anesthesiology and Perioperative Medicine, People's Hospital of Zhengzhou University, Henan Provincial People's Hospital, Zhengzhou, China.
概括
儿童早期接触全身麻醉 (GA) 与注意力缺陷多动症障碍 (ADHD) 的风险增加有关. 诸如重复的GA暴露,更长的持续时间,男性性别和中枢神经系统手术等因素也会提高儿童的ADHD风险.
科学领域:
- 儿科麻醉学 儿科麻醉学
- 神经发育障碍 神经发育障碍
- 流行病学 流行病学
背景情况:
- 儿童早期全身麻醉 (GA) 暴露与注意力缺陷多动障碍 (ADHD) 风险之间的关联仍然不清楚,之前的研究产生了相互矛盾的结果.
- 这项以人口为基础的队列研究通过调查大规模台湾队列中GA暴露和ADHD风险之间的潜在联系来解决不确定性.
研究的目的:
- 确定暴露于GA的儿童与未暴露组的ADHD发病率 (IR) 和发病率比率 (IRR).
- 为了确定与儿童早期GA暴露后ADHD发展相关的特定风险因素.
主要方法:
- 一项基于人口的队列研究,涉及15,072名年龄在0-3岁的儿童在台湾GA暴露后住院超过1天 (2004-2014).
- 倾向性得分匹配 (PSM) 用于1:1匹配GA暴露和非暴露组,采用台湾母婴健康数据库 (TMCHD).
- 普森回归模型被用来分析ADHD发病率和比率.
主要成果:
- 与非GA组相比,GA组的ADHD发病率显著高于GA组 (1万人年122.45人),而非GA组的ADHD发病率则高于GA组 (1万人年64.15人).
- 在GA组中,ADHD的发病率比率 (IRR) 为1.39 (95% CI:1.26,1.55),表明风险增加了39%.
- 严重的ADHD风险因素包括多次GA暴露,更长的GA持续时间,男性性别和中枢神经系统手术.
结论:
- 研究结果表明,幼儿时代GA暴露与患ADHD的风险增加之间存在显著的相关性.
- 在接受外科手术的儿童中,GA暴露被确定为ADHD的潜在风险因素.
- 该研究强调了GA暴露的数量,持续时间,男性性别和中枢神经系统手术作为儿童多动症的关键风险因素.
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