Ashwal S, Bale J F, Coulter D L, Eiben R, Garg B P, Hill A, Myer E C, Nordgren R E, Shewmon D A, Sunder T R
Department of Pediatrics, Loma Linda University School of Medicine, CA 92350.
Ann Neurol. 1992 Oct;32(4):570-6. doi: 10.1002/ana.410320414.
Increasing concern about children in a persistent vegetative state (PVS) prompted a survey of members of the Child Neurology Society regarding aspects of the diagnosis and management of this disorder. Major findings of those responding to this survey (26% response rate) were as follows: (1) 93% believed that a diagnosis of PVS can be made in children, but only 16% believed that this applied to infants younger than 2 months and 70% in the 2-month to 2-year group; (2) a period of 3 to 6 months was believed to be the minimum observation period required before a diagnosis of PVS could be made; (3) 86% believed that the age of the patient would affect the duration of time needed to make the diagnosis of PVS; (4) 78% thought a diagnosis of PVS could be made in children with severe congenital brain malformations; (5) 75% believed that neurodiagnostic studies would be of value and supportive of the clinical diagnosis of PVS; (6) members' opinions as to the average life expectancy (in years) for the following age groups after the patients were considered vegetative were: newborn to 2 months, 4.1; 2 months to 2 years, 5.5; 2 to 7 years, 7.3; and more than 7 years, 7.4; (7) 20% believed that infants and children in a PVS experience pain and suffering; and (8) 75% "never" withhold fluid and nutrition from infants and children in a PVS and 28% "always" give medication for pain and suffering.(ABSTRACT TRUNCATED AT 250 WORDS)
对处于持续性植物状态(PVS)儿童的日益关注促使对儿童神经学会成员就该疾病的诊断和管理方面进行了一项调查。对此次调查做出回应的成员(回应率为26%)的主要调查结果如下:(1)93%的人认为可以对儿童做出PVS的诊断,但只有16%的人认为这适用于2个月以下的婴儿,而在2个月至2岁组中这一比例为70%;(2)3至6个月的时间被认为是做出PVS诊断之前所需的最短观察期;(3)86%的人认为患者年龄会影响做出PVS诊断所需的时间;(4)78%的人认为可以对患有严重先天性脑畸形的儿童做出PVS诊断;(5)75%的人认为神经诊断研究对PVS的临床诊断有价值且有支持作用;(6)成员们对患者进入植物状态后以下年龄组的平均预期寿命(以年计)的看法是:新生儿至2个月,4.1;2个月至2岁,5.5;2至7岁,7.3;7岁以上,7.4;(7)20%的人认为处于PVS的婴儿和儿童会经历疼痛和痛苦;(8)75%的人“从不”不给处于PVS的婴儿和儿童提供液体和营养,28%的人“总是”给他们使用缓解疼痛和痛苦的药物。(摘要截断于250字)