Sistino Joseph J, Atz Andrew M, Simpson Kit N, Ellis Charles, Ikonomidis John S, Bradley Scott M
1Medical University of South Carolina,College of Health Professions,Charleston,United States of America.
2Medical University of South Carolina,College of Medicine,Charleston,United States of America.
Cardiol Young. 2015 Apr;25(4):663-9. doi: 10.1017/S1047951114000547. Epub 2014 Apr 28.
We sought to determine the prevalence of attention-deficit/hyperactivity disorder in a population of children who underwent neonatal heart surgery involving repair of the aortic arch for Norwood Stage I, interrupted aortic arch, and combined repair of aortic coarctation with ventricular septal defect.
Children between the ages of 5 and 16 were surveyed using the ADHD-IV and the Child Heath Questionnaire-50. Classification as attention-deficit/hyperactivity disorder was defined for this study as either a parent-reported diagnosis of attention-deficit/hyperactivity disorder or ADHD-IV inattention score of ⩾93 percentile.
Of the 134 surveys, 57 (43%) were returned completed. A total of 25 (44%) children either had a diagnosis of attention-deficit/hyperactivity disorder and/or ADHD-IV inattention score ⩾93 percentile. Eleven of the 13 (85%) children with interrupted aortic arch, 3 of the 7 (42.9%) children with combined coarctation/ventricular septal defect repair, and 9 of the 33 (27.3%) children with hypoplastic left-heart syndrome were classified as having attention-deficit/hyperactivity disorder. Only 7 of the 25 (28%) children received medical treatment for this condition. Quality of life indicators in the Child Heath Questionnaire-50 Questionnaire were highly correlated with the ADHD-IV scores.
The risks for the development of attention-deficit/hyperactivity disorder are multifactorial but are significantly increased in this post-surgical population. This study revealed a low treatment rate for attention-deficit/hyperactivity disorder, and a significant impact on the quality of life in these children.
我们试图确定在接受新生儿心脏手术(包括诺伍德一期主动脉弓修复、主动脉弓中断修复以及主动脉缩窄合并室间隔缺损联合修复)的儿童群体中注意力缺陷/多动障碍(ADHD)的患病率。
使用ADHD-IV和儿童健康问卷-50对5至16岁的儿童进行调查。本研究将注意力缺陷/多动障碍的分类定义为家长报告的注意力缺陷/多动障碍诊断或ADHD-IV注意力不集中得分处于≥第93百分位。
在134份调查问卷中,57份(43%)被完整返还。共有25名(44%)儿童被诊断为患有注意力缺陷/多动障碍和/或ADHD-IV注意力不集中得分≥第93百分位。13名主动脉弓中断儿童中的11名(85%)、7名主动脉缩窄/室间隔缺损联合修复儿童中的3名(42.9%)以及33名左心发育不全综合征儿童中的9名(27.3%)被归类为患有注意力缺陷/多动障碍。25名儿童中只有7名(28%)接受了针对该病症的药物治疗。儿童健康问卷-50中的生活质量指标与ADHD-IV得分高度相关。
注意力缺陷/多动障碍发展的风险是多因素的,但在这个术后群体中显著增加。本研究显示注意力缺陷/多动障碍的治疗率较低,并且对这些儿童的生活质量有重大影响。