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[公式:见正文]先天性心脏病:儿科神经心理学家入门指南。

[Formula: see text]Congenital heart disease: A primer for the pediatric neuropsychologist.

作者信息

Cassidy Adam R, Ilardi Dawn, Bowen Susan R, Hampton Lyla E, Heinrich Kimberley P, Loman Michelle M, Sanz Jacqueline H, Wolfe Kelly R

机构信息

a Department of Psychiatry , Boston Children's Hospital, Harvard Medical School , Boston , MA , USA.

b Department of Neuropsychology , Children's Healthcare of Atlanta, Emory University , Atlanta , GA , USA.

出版信息

Child Neuropsychol. 2018 Oct;24(7):859-902. doi: 10.1080/09297049.2017.1373758. Epub 2017 Sep 6.

Abstract

Congenital heart disease (CHD) affects millions of people worldwide, including over one million children in the United States. Approximately 25% of children born with CHD require intensive surgical intervention within the first year of life. Despite improved rates of survival into adulthood - rates that exceed 90% in the modern era - children and adolescents with CHD remain at risk for neurological injury and a range of neurobehavioral and psychosocial challenges that pose a threat to quality of life across the lifespan. Consequently, as experts in both clinical psychology and brain development, neuropsychologists are becoming increasingly involved in cardiac follow-up and monitoring to promote optimal developmental outcomes. The primary objective of this paper is to provide an evidence-based, clinically-oriented primer on CHD for pediatric neuropsychologists working with this growing population of survivors. Following an introduction to current standard-of-care guidelines for managing children and adolescents with CHD, we present an overview of brain development within the context of CHD, review neuropsychological outcomes, examine factors influencing variability in outcomes, and discuss implications and strategies for clinical assessment.

摘要

先天性心脏病(CHD)影响着全球数百万人,其中包括美国的100多万名儿童。患有CHD的儿童中,约25%在出生后的第一年内需要进行强化手术干预。尽管成年后的生存率有所提高——在现代,这一比例超过了90%——但患有CHD的儿童和青少年仍然面临神经损伤以及一系列神经行为和社会心理挑战的风险,这些挑战对其一生的生活质量构成威胁。因此,作为临床心理学和大脑发育方面的专家,神经心理学家越来越多地参与到心脏疾病的随访和监测中,以促进最佳的发育结果。本文的主要目的是为从事这一不断增加的幸存者群体工作的儿科神经心理学家提供一份基于证据、以临床为导向的先天性心脏病入门指南。在介绍了目前管理患有CHD的儿童和青少年的标准护理指南后,我们概述了先天性心脏病背景下的大脑发育,回顾了神经心理学结果,研究了影响结果变异性的因素,并讨论了临床评估的意义和策略。

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