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生物反馈治疗(biofeedback therapy)是一种生物行为疗法,通过电子工程技术,把一些不能或不易被人体感知的生理和病理活动,转化为声音、图像等可被或易被感知的信息,利用生物反馈机制,让患者根据其观察到的自身生理活动信息来调整生理活动,以达到治疗疾病的目的。生物反馈是近代心理学、精神生理学与物理医学、机能恢复治疗学的成功结合,它的发展充实了行为医学的内容。近20年来,生物反馈技术广泛应用于小儿功能性便秘和大便失禁等肛直肠功能紊乱的治疗。1生物反馈及其机制20世纪20年代美国的Jacobson通过肌电描记方法使患者从肌电活动中了…     

Evaluation and management of upper airway disorders in children

Upper airway disorders in children may be divided into those that are congenital in origin and those that are acquired. The presentation and management of these disorders is significantly influenced both by the anatomic location of the pathology, which is usually obstructive in nature, and by the severity of the obstruction. This discussion provides an overview of the presentation, diagnosis, management, and potential complications of the most commonly seen upper airway disorders. These disorders are presented within an anatomic framework, progressing from proximal at the nares to distal at the carina.     

儿童功能性胃肠病与胃肠动力疾病

近 2 0年由于社会生活发生根本性变化 ,儿科消化系统疾病谱亦随之改变 ,功能性便秘、功能性腹痛、功能性消化不良及肠易激综合征等发病率逐年上升。上述疾病分类、诊断标准、治疗原则等尚存在很多模糊概念。实际情况是 ,2 0世纪 80年代以前 ,功能性胃肠病 (functionalgastrointestinaldis orders,FGIDs)的研究主要集中于胃肠运动障碍 ,在一定程度上胃肠运动障碍被认为是FGIDs的代名词。对一组慢性、反复发作的“具有消化道症状 ,而无法以器质性疾病或生化异常解释”的消化道症状的不同组合曾多次进行专题讨论 ,并成立FGIDs专家委员会于…     

功能性构音障碍儿童的听觉事件相关电位研究

目的：探讨功能性构音障碍（FAD）患儿中枢听觉加工特点及儿童FAD的可能病因。 方法：选择符合 FAD 诊断标准的 27 例患儿作为病例组, 年龄匹配的正常儿童 50 例作为对照组,比较病例组与对照组个人语言发育史阳性病史率,检测二组儿童事件相关电位,比较其失匹配负波（MMN）形态学、潜伏期及峰振幅。结果：病例组个人语言发育史中阳性病史比例显著高于对照组,差异有统计学意义（70% vs 8%,P0.05）。结论：中枢听觉加工时间延长可能是儿童FAD的发病原因之一。     

Non-pharmacological management of abdominal pain-related functional gastrointestinal disorders in children

Background

Abdominal pain-related functional gastrointestinal disorder (AP-FGID) comprises of 4 main conditions: functional dyspepsia, irritable bowel syndrome, abdominal migraine and functional abdominal pain. AP-FGIDs are diagnosed clinically based on the Rome IV criteria for FGIDs of childhood. There is limited evidence for pharmacological therapies.

Data sources

This review article discusses nonpharmacological management of AP-FGID based on the current literature including systematic reviews, randomized controlled trials, cohort and case control studies. We aim to provide a comprehensive overview on the available evidence for the pediatricians and pediatric gastroenterologists involved in managing children with AP-FGID.

Results

Managing AP-FGIDs can be challenging. This should follow a stepwise approach with focused history, identification of “red flag” signs and symptoms, physical examination and investigations done following initial consultation. Family needs explaining that there is nothing seriously wrong with the child’s abdomen. This explanation and reassurance can achieve symptom control in large number of cases. Non-pharmacological interventions are delivered through lifestyle and dietary changes and bio-psychosocial therapies. Dietary interventions vary depending on the type of AP-FGID. Bio-psychosocial therapies such as hypnotherapy, cognitive behavioral therapy and yoga aim at stress reduction.

Conclusion

There is increasing evidence for use of non-pharmacological interventions in children with APFGID.