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轻度创伤性脑损伤患儿持续性行为问题的症状。

Symptoms of Persistent Behavior Problems in Children With Mild Traumatic Brain Injury.

作者信息

Taylor H Gerry, Orchinik Leah J, Minich Nori, Dietrich Ann, Nuss Kathryn, Wright Martha, Bangert Barbara, Rusin Jerome, Yeates Keith Owen

机构信息

Departments of Pediatrics (Drs Taylor and Wright and Ms Minich) and Psychological Sciences (Ms Orchinik), Case Western Reserve University, Cleveland, Ohio; Rainbow Babies & Children's Hospital, University Hospitals Case Medical Center, Cleveland, Ohio (Drs Taylor and Wright); Departments of Radiology and Neurosurgery, University Hospitals Health System, Cleveland, Ohio (Dr Bangert); Departments of Emergency Medicine (Drs Dietrich and Nuss) and Radiology (Dr Rusin) and Center for Biobehavioral Health, The Research Institute (Dr Yeates), Nationwide Children's Hospital, Columbus, Ohio; and Department of Pediatrics, The Ohio State University College of Medicine, Columbus (Dr Yeates). Dr Yeates is now with the Department of Psychology, University of Calgary, Calgary, Alberta, Canada.

出版信息

J Head Trauma Rehabil. 2015 Sep-Oct;30(5):302-10. doi: 10.1097/HTR.0000000000000106.

Abstract

OBJECTIVE

To investigate the effects of mild traumatic brain injury (mTBI) in children on symptom ratings of behavior problems across the first-year postinjury.

SETTING

Emergency departments of 2 regional children's hospitals.

PARTICIPANTS

Parents of 176 children with mTBI and 90 children with orthopedic injury aged 8 to 15 years.

DESIGN

Group comparisons of postinjury parent and teacher ratings of child behavior problems controlling for background factors.

MAIN MEASURES

Child Behavior Checklist and Teacher's Report Form.

RESULTS

For younger but not older children in the sample, children with mTBI compared with children with orthopedic injury had higher postinjury ratings on the Child Behavior Checklist Total Behavior Problem scale (t264 = 3.34, P < .001) and higher rates of T-scores of 60 or more on this scale (odds ratio = 3.00; 95% confidence interval, 1.33-6.77; P = .008). For children with mTBI, hospitalization, motor vehicle accidents, loss of consciousness, and magnetic resonance imaging abnormality were associated with higher parent or teacher ratings.

CONCLUSIONS

School-aged children with mTBI are at risk for persistent symptoms of behavior problems, especially if mTBI is more severe or occurs at a younger age. The findings justify monitoring of behavior long after injury and further research to identify risk factors for these symptoms and their association with clinical disorders.

摘要

目的

研究儿童轻度创伤性脑损伤(mTBI)对伤后第一年行为问题症状评分的影响。

设置

两家地区儿童医院的急诊科。

参与者

176名8至15岁mTBI患儿和90名骨科损伤患儿的家长。

设计

在控制背景因素的情况下,对伤后家长和教师对儿童行为问题的评分进行组间比较。

主要测量指标

儿童行为量表和教师报告表。

结果

在样本中,年龄较小而非较大的mTBI患儿与骨科损伤患儿相比,在儿童行为量表总行为问题量表上的伤后评分更高(t264 = 3.34,P < .001),且该量表上T分达到60分及以上的比例更高(优势比 = 3.00;95%置信区间,1.33 - 6.77;P = .008)。对于mTBI患儿,住院治疗、机动车事故、意识丧失和磁共振成像异常与家长或教师的较高评分相关。

结论

患有mTBI的学龄儿童有出现持续性行为问题症状的风险,尤其是当mTBI更严重或发生在较年轻时。这些发现证明在受伤后很长时间都要对行为进行监测,并进一步研究以确定这些症状的风险因素及其与临床疾病的关联。

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