Oberhuber Raphael D, Huemer Sonja, Mair Rudolf, Sames-Dolzer Eva, Kreuzer Michaela, Tulzer Gerald
Children's Heart Center Linz, Kepler University Hospital, Krankenhausstrasse 26, 4020, Linz, Austria.
Department of Inclusive Education, University of Education Upper Austria, Kaplanhofstrasse 40, 4020, Linz, Austria.
Pediatr Cardiol. 2017 Aug;38(6):1089-1096. doi: 10.1007/s00246-017-1623-8. Epub 2017 May 16.
Neurological and radiologic research results show an abnormal cerebral microstructure as well as abnormal neurodevelopment in patients treated for hypoplastic left heart syndrome. The aim of this study was to assess the varying cognitive performance these children have developed in dependence upon prenatal diagnosis, surgical techniques, surgical learning effects, anatomy, perfusion techniques, gender, pedagogic, and sociodemographic parameters in comparison to age-adjusted normative values. School-age children (6.3-16.9 years) with hypoplastic left heart syndrome, who were treated at the Children's heart Center Linz between 1997 and 2009, (n = 74), were surveyed in reference to cognitive achievements. 43 patients were examined prospectively by psychologists using the Wechsler intelligence scale for children IV in order to determine the respective total intelligence quotient index for each child's developmental stage. The mean index was 84.5 (percentile rank 26.4). The statistical spread and standard deviation ranged from a minimum of 40 to a maximum of 134 ± 20.8. The results for verbal comprehension, perceptual reasoning, and processing speed corresponded with total index results and were thus lower than the mean value of the normative values. The assessment of working memory showed results in the average. Prenatal diagnosis, type of lung perfusion, anatomy, and various cerebral perfusion techniques did not significantly affect the cognitive results of the patients. The results show that hypoplastic left heart syndrome patients can be successfully tutored formally as well as personally in cognitive areas, although when compared to healthy children, they showed lower results for intellectual area parameters.
神经学和放射学研究结果显示，接受过左心发育不全综合征治疗的患者存在大脑微观结构异常以及神经发育异常。本研究的目的是评估这些儿童在认知能力方面的差异，这些差异取决于产前诊断、手术技术、手术学习效果、解剖结构、灌注技术、性别、教育方式以及社会人口统计学参数，并与年龄调整后的标准值进行比较。对1997年至2009年间在林茨儿童心脏中心接受治疗的左心发育不全综合征学龄儿童（6.3 - 16.9岁，n = 74）进行了认知成就调查。43名患者由心理学家使用韦氏儿童智力量表第四版进行前瞻性检查，以确定每个儿童发育阶段各自的总智商指数。平均指数为84.5（百分等级26.4）。统计分布和标准差范围从最小值40到最大值134±20.8。言语理解、知觉推理和处理速度的结果与总指数结果一致，因此低于标准值的平均值。工作记忆评估结果处于平均水平。产前诊断、肺灌注类型、解剖结构和各种脑灌注技术对患者的认知结果没有显著影响。结果表明，左心发育不全综合征患者在认知领域可以成功地接受正式和个性化辅导，尽管与健康儿童相比，他们在智力领域参数方面的结果较低。
