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婴儿早期接受鼻咽插管治疗的孤立性罗宾序列患儿的神经发育情况

Neurological Development of Children With Isolated Robin Sequence Treated With Nasopharyngeal Intubation in Early Infancy.

作者信息

Alencar Tatiane Romanini Rodrigues, Marques Ilza Lazarini, Bertucci Alvaro, Prado-Oliveira Rosana

出版信息

Cleft Palate Craniofac J. 2017 May;54(3):256-261. doi: 10.1597/14-228. Epub 2016 Apr 4.

Abstract

The study assessed the neurodevelopment of children with isolated Robin sequence (IRS) and evaluated if children treated exclusively with nasopharyngeal intubation (NPI) present delay in neurological development. The prospective and cross-sectional study was conducted at the Hospital for Rehabilitation of Craniofacial Anomalies, Brazil. Children with IRS were divided into two groups according to the type of treatment in early infancy: 38 were treated with NPI (more severe cases) and 24 with postural treatment (less severe cases). Regarding interventions, children were assessed at 2 to 6 years of age using the Denver II Developmental Screening Test (Denver II) and Neurological Evolutionary Examination (NEE). According to Denver II, 73.7% in the NPI group and 79.2% in the postural group presented normal development. This result was similar to the results of different studies in the literature with typical population. Considering all areas of development, there were no significant differences in Denver II between the NPI and postural groups (P = .854). In the NPI group, 89.5% of children and 87.5% in the postural group presented normal development in NEE. Language was the most affected area, as 18.4% and 20.8% of children in NPI and postural group, respectively, presented risk for delay in the Denver II. The increased risk for delay in language area was probably due to anatomical conditions of the muscles involved in speech, and to hearing oscillations, as 47.4% in NPI group and 58.3% in postural group underwent myringotomy. IRS treated with NPI had neurological development similar to those in less severe cases. Children treated exclusively with NPI did not present delay in neurological development.

摘要

该研究评估了孤立性罗宾序列征(IRS)患儿的神经发育情况,并评估了仅接受鼻咽插管(NPI)治疗的患儿是否存在神经发育延迟。这项前瞻性横断面研究在巴西颅面畸形康复医院进行。患有IRS的患儿根据婴儿早期的治疗类型分为两组:38例接受NPI治疗(病情较重的病例),24例接受体位治疗(病情较轻的病例)。关于干预措施,使用丹佛发育筛查测验(丹佛II)和神经进化检查(NEE)在2至6岁时对患儿进行评估。根据丹佛II评估,NPI组73.7%的患儿和体位治疗组79.2%的患儿发育正常。这一结果与文献中针对典型人群的不同研究结果相似。考虑到所有发育领域,NPI组和体位治疗组在丹佛II评估中的结果无显著差异(P = 0.854)。在NPI组中,89.5%的患儿和体位治疗组中87.5%的患儿在NEE评估中发育正常。语言是受影响最大的领域,NPI组和体位治疗组分别有18.4%和20.8%的患儿在丹佛II评估中存在发育延迟风险。语言领域发育延迟风险增加可能是由于参与言语的肌肉的解剖条件以及听力波动,因为NPI组47.4%的患儿和体位治疗组58.3%的患儿接受了鼓膜切开术。接受NPI治疗的IRS患儿的神经发育与病情较轻病例的患儿相似。仅接受NPI治疗的患儿未出现神经发育延迟。

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