Huang Hai-Bo, Wan Xue-Qing, Monteiro Olivia, Lam Lawrence T, Tam Paul Kwong-Hang
Faculty of Medicine, Taipa, Macau University of Science and Technology, Avenida WaiLong, Macau, China.
Department of Neonatology, University of Hong Kong-Shenzhen Hospital, Shenzhen, China.
Pediatr Surg Int. 2025 Apr 23;41(1):123. doi: 10.1007/s00383-025-06012-y.
To better target future educational outcomes of pediatric patients with Hirschsprung disease (HSCR), we conducted a systematic review without meta-analysis on the impact of HSCR on school functioning (SF). PubMed, Embase, Scopus, Web of Science, Cochrane, PsycINFO, and ERIC were searched from inception to December 2023, following the systematic reviews of PRISMA guidelines. Original studies where SF was measured as one of the outcomes were identified by searching relevant databases and manual searching. Data describing the impact of HSCR on SF were extracted. Screening, data extraction, and quality assessment were performed by at least two authors. 2042 articles were identified, 1300 records were screened after removal of duplicates. Forty records were assessed for eligibility and twelve studies which evaluated the SF in children between the ages of 6 and 17 with HSCR were analyzed. Among the twelve studies, five were retrospective cohort studies, one prospective cohort study, one longitudinal cohort study, and five case-control studies. Five studies measured general SF including attention, memory, schoolwork, and missing school. Among these five studies, three showed domain scores for SF lower than matched healthy controls or the reference normative population. Additionally, peer relationship problems/peer rejection/bullying as a specific area of SF were reported in another five studies using three different assessment instruments. Other specific aspects of SF such as school absences, school environment, school attitude, school performance, interpersonal relationships, and education services were assessed by different generic or disease-specific scales in the included studies. The lack of data measuring individual aspects made it hard to conclude the effects of HSCR in these aspects. HSCR negatively impacted general SF, especially in peer relationships. Due to the lack of studies utilizing standardized measures of SF on HSCR children, a multicenter larger sample size and longitudinal study is urgently needed, to provide robust evidence and to help inform targeted strategies to optimize educational outcomes for students with HSCR.
为了更好地针对患有先天性巨结肠症（HSCR）的儿科患者未来的教育成果，我们进行了一项无荟萃分析的系统评价，以评估HSCR对学校功能（SF）的影响。按照PRISMA指南的系统评价要求，检索了从创刊到2023年12月的PubMed、Embase、Scopus、Web of Science、Cochrane、PsycINFO和ERIC数据库。通过检索相关数据库和手工检索，确定了将SF作为结果之一进行测量的原始研究。提取了描述HSCR对SF影响的数据。筛选、数据提取和质量评估由至少两名作者进行。共识别出2042篇文章，去除重复记录后筛选出1300条记录。对40条记录进行了资格评估，并分析了12项评估6至17岁HSCR儿童SF的研究。在这12项研究中，5项为回顾性队列研究，1项为前瞻性队列研究，1项为纵向队列研究，5项为病例对照研究。5项研究测量了包括注意力、记忆力、学业和缺课在内的一般SF。在这5项研究中，3项显示SF的领域得分低于匹配的健康对照组或参考标准人群。此外，另外5项研究使用三种不同的评估工具报告了作为SF特定领域的同伴关系问题/同伴排斥/欺凌。纳入研究中通过不同的通用或疾病特异性量表评估了SF的其他特定方面，如缺课、学校环境、学校态度、学业成绩、人际关系和教育服务。由于缺乏测量各个方面的数据，很难得出HSCR在这些方面的影响结论。HSCR对一般SF有负面影响，尤其是在同伴关系方面。由于缺乏对HSCR儿童使用标准化SF测量方法的研究，迫切需要进行多中心、更大样本量的纵向研究，以提供有力证据，并帮助制定有针对性的策略，以优化HSCR学生的教育成果。
