Department of Pediatrics, Dalhousie University, IWK Health Centre, Halifax, Nova Scotia, Canada.
Ann Neurol. 2011 Mar;69(3):437-44. doi: 10.1002/ana.22393. Epub 2011 Mar 9.
Chronic neurological disorders in children have significant effects on adult medical and social function. Transition and then formal transfer of care from pediatric to adult services is a complex process, although there are virtually no objective data to inform physicians about the most effective approach. Some neurological disorders that start in children are a danger to society if poorly treated in adulthood, some disorders that were previously lethal in childhood now permit survival well into adulthood, and others are static in childhood but progressive in adulthood. Some disorders remit or are cured in childhood but continue to have serious comorbidity in adulthood, whereas others are similar and persistent in children and adults. Maturity, provision of information, and cognitive problems are confounders. We discuss several models of transition/transfer but prefer a joint pediatric/adult transition clinic. We make a series of suggestions about how to improve the transition/transfer process with the hope of better medical and social adult outcome for children with neurological disorders.
儿童慢性神经障碍对其成年后的医学和社会功能有显著影响。从儿科到成人服务的过渡和正式交接是一个复杂的过程，尽管实际上没有客观数据可以告知医生哪种方法最有效。一些在儿童时期开始的神经障碍如果在成年期治疗不当，会对社会构成威胁，一些以前在儿童期致命的疾病现在可以让患者成年后存活下来，还有一些在儿童期处于静止状态但在成年期进展，一些在儿童期缓解或治愈但在成年期仍有严重合并症，而另一些在儿童期和成年期相似且持续存在。成熟度、信息提供和认知问题是混杂因素。我们讨论了几种过渡/转移模式，但更倾向于联合儿科/成人过渡诊所。我们提出了一系列关于如何改进过渡/转移过程的建议，希望改善患有神经障碍的儿童的医疗和社会成年结局。
