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小儿轻度创伤性脑损伤后的脑震荡症状。

Concussive Symptoms Following Pediatric Mild Traumatic Brain Injury.

机构信息

Melbourne School of Psychological Sciences, University of Melbourne, Australia (Ms Yumul and Drs McKinlay, Anderson, and Catroppa); Murdoch Children's Research Institute, Melbourne, Australia (Ms Yumul and Drs McKinlay, Anderson, and Catroppa); Royal Children's Hospital, Melbourne, Australia (Ms Yumul and Drs Anderson and Catroppa); Department of Psychology, University of Canterbury, Christchurch, New Zealand (Dr McKinlay); and Department of Emergency Medicine, Canterbury District Health Board, Christchurch, New Zealand (Dr Than).

出版信息

J Head Trauma Rehabil. 2020 Jul/Aug;35(4):279-287. doi: 10.1097/HTR.0000000000000565.

Abstract

OBJECTIVES

To determine the proportion of children with postconcussive symptoms (PCSs) and to explore the influence of noninjury and injury factors on parents' PCS report at 3 months postinjury.

DESIGN

A cross-sectional analysis of the 3-month postinjury data from a larger, prospective, longitudinal study.

METHODS

Parents and their child aged 2 to 12 years who presented at the emergency department with either a mild traumatic brain injury (mTBI) or a superficial injury to the head (SIH) were recruited. Parents reported their child's symptoms at the time of injury and at 3 months postinjury. Child, family/parent, and injury characteristics were considered as potential predictors. Logistic regression was conducted to determine which factors increase the likelihood of parents' PCS report.

RESULTS

At 3 months postinjury, 30% and 13% of children in the mTBI and SIH groups exhibited 1 or more symptoms, respectively. On the other hand, 18% (mTBI) and 8% (SIH) continued to have ongoing problems when 2 or more symptoms were considered at follow-up. The final model, which included child's sex, injury group, number of symptoms at the time of injury, and parental stress, had a significant predictive utility in determining parents' report of 1 or more symptoms at follow-up. Only parental stress continued to be a significant predictor when considering 2 or more symptoms at 3 months postinjury.

CONCLUSIONS

Children with mTBI have worse outcomes than children with SIH at follow-up, with parents more likely to report 1 or more ongoing symptoms if their children had an mTBI. Postinjury assessment of parental stress and ongoing symptom monitoring in young children with mTBI will allow for timely provision of support for the family.

摘要

目的

确定患有脑震荡后症状(PCS)的儿童比例,并探讨非损伤和损伤因素对父母在受伤后 3 个月报告 PCS 的影响。

设计

对一项较大的前瞻性纵向研究的受伤后 3 个月的数据进行横断面分析。

方法

招募了在急诊科就诊的 2 至 12 岁儿童及其父母,他们患有轻度创伤性脑损伤(mTBI)或头部浅表损伤(SIH)。父母在受伤时和受伤后 3 个月报告孩子的症状。考虑了儿童、家庭/父母和损伤特征作为潜在预测因素。进行逻辑回归分析以确定哪些因素增加父母报告 PCS 的可能性。

结果

在受伤后 3 个月时,mTBI 和 SIH 组分别有 30%和 13%的儿童出现 1 种或多种症状。另一方面,当在随访中考虑到 2 种或更多症状时,18%(mTBI)和 8%(SIH)的儿童仍存在持续问题。最终模型包括儿童的性别、损伤组、受伤时的症状数和父母的压力,该模型在确定父母在随访时报告 1 种或多种症状方面具有显著的预测效用。只有当考虑到受伤后 3 个月时的 2 种或更多症状时,父母的压力才仍然是一个重要的预测因素。

结论

与 SIH 组相比,mTBI 组的儿童在随访时的结局更差,如果他们的孩子患有 mTBI,父母更有可能报告 1 种或多种持续症状。对 mTBI 幼儿进行受伤后父母压力评估和持续症状监测,将为家庭提供及时的支持。

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