感觉统合治疗儿童感觉统合失调198例

我院从 2 0 0 0年成立感觉统合治疗中心以来 ,共收治感觉统合失调儿童 198例 ,现将临床资料报告如下。对象与方法一、对象　均为 2 0 0 0年 6月～ 2 0 0 2年 2月来本中心咨询和测试的儿童 ,并符合感觉统合失调评定标准[1] 共 198例 ,男 14 5例 ,女 5 3例 ;年龄 4～ 10岁。二、方法　采用集体训练、个别调整训练和家长配合三种相结合的治疗方法。集体训练依据陈文德教授的感觉统合指导进行训练。按就诊顺序随机编组 ,每组儿童制订循序渐进的训练方案 ,采用滑板、平衡木、触觉球等器材 ,以游戏形式进行形体、触觉、精细动作及记忆、视、听力等…     

感觉统合失调及其临床意义

本文介绍了感觉统合失调的有关概念，综述了前庭平衡觉、触觉、听觉等感觉与统合失调的关系。简述了感觉统合失调治疗的理论依据及其临床应用情况。     

感觉统合失调的研究进展

近年来 ,国内引进了感觉统合训练新技术 ,用于某些疾病的辅助治疗或矫治某些行为症状 ,而临床医师对此了解甚少。现就感觉统合 (ｓｅｎｓｏｒｙｉｎｔｅｇｒａｔｉｏｎ ,ＳＩ)与儿童感觉统合失调 (ｓｅｎｓｏｒｙｉｎｔｅｇｒａｔｉｖｅｄｙｓｆｕｎｃｔｉｏｎ ,ＳＩＤ)的有关概念、内涵、主要临床表现 ,感觉统合失调治疗的理论基础及其临床应用情况综述如下。一、感觉统合失调的有关概念1.ＳＩ的概念 :1969年美国南加州大学临床心理学家ＪｅａｎＡｙｒｅｓ将脑神经学与发展心理学相结合 ,根据对脑功能研究、职业治疗及实验研究结果 ,首先系…     

感觉统合训练对感觉统合失调儿童疗效初步观察

目的观察感觉统合训练对感觉统合失调的疗效。方法对32例确诊为重度感觉统合失调儿童，进行3个疗程感觉统合训练，在训练前以及训练结束后进行感觉统合量表检测，比较训练前以及训练后量表评分，确定疗效。结果训练前以及训练后感觉统合量表评分差异有统计学意义（P〈0．01）。结论感觉统合训练对感觉统合失调儿童有较好的疗效，值得临床推广。     

上海市幼大班儿童感觉统合失调的调查分析

感觉统合是指机体在环境内有效利用自己的感官 ,从环境中获得不同感觉通路的信息输入大脑 ,大脑对信息进行加工处理 ,并作出适应性反应的能力。这一过程障碍时称为感觉统合失调。感觉统合是每个孩子成长过程中必须有的学习过程。如感觉统合失调 ,大脑和身体将不能和谐有效地运作 ,入学后就不能很好的发挥学习的潜能。本研究试图探讨上海学前儿童 (幼大班 )的感觉统合失调率及其影响因素。对象和方法一、研究对象以整群抽样方法抽取全市１９个区、县的一、二类幼儿园各１所 ,共计１３７７名幼大班儿童 ,其中男孩６８３名 ,女孩６９４名 ,男女…     

儿童学习困难与感觉统合失调的相关性探讨

近年来 ,我科儿童学习困难门诊对 2 6 0名学习困难儿童进行了感觉统合能力发展评定 ,报告如下。对象及方法一、对象　以家长认为儿童学习困难且上学期期终考试成绩较差 (语文、数学总成绩列班级后 15名 )、小学 1～ 6年级的郑州市市区小学生为对象。 2 6 0名中男 170例 ,女 90例年龄 6 .5～ 14.1ａ,平均 8.9ａ。郑州市市区某小学 1～ 6年级学生男 170名、女 90名为对照组。二、方法　 1.采用中国联合型瑞文测验 (ＣＲＴ -Ｃ2 )对两组儿童进行智商筛查 ,经筛查不正常者进行韦氏 (ＷＩＳＣ -ＣＲ)法智力测验 ,低于 70分不列入统计对象。 2 .采…     

剖宫产与学龄前儿童感觉统合失调的前瞻性队列研究

目的 采用前瞻性队列研究,评价剖宫产与学龄前儿童感觉统合失调的关联。 方法 依托上海交通大学医学院附属新华医院和附属国际和平妇幼保健院2012年建立的多中心母婴队列,于2017年采用儿童感觉统合能力发展评定量表,从前庭平衡、触觉防御和本体觉3个维度评价392名学龄前儿童感觉统合功能。剖宫产出生为暴露因素,阴道分娩者作为对照组。采用多因素logistic回归分析评估剖宫产与感觉统合各维度失调的关联。 结果 学龄前儿童感觉统合失调率为21.9%（86/392）,前庭平衡、触觉防御和本体觉失调率分别为5.9%（23/392）、5.4%（21/392）和15.1%（59/392）。调整母亲分娩年龄、母亲受教育程度及儿童出生情况等混杂因素后,剖宫产儿童发生本体觉失调的风险性显著增加（RR=4.16,95%CI：1.41~12.30,P<0.05）。按性别分层分析发现,剖宫产男童本体觉失调的发生风险高于阴道分娩男童（RR=5.75,95%CI：1.26~26.40,P<0.05）。 结论 剖宫产能显著增加学龄前儿童本体觉失调的发生风险,尤其是对男童的影响更为明显。     

感觉统合失调及其临床意义

本文介绍了感觉统合失调的有关概念，综述了前庭平衡觉、触觉、听觉等感觉与统合失调的关系。简述了感觉统合失调治疗的理论依据及其临床应用情况。     

遗尿症儿童感觉统合能力的研究

目的：分析原发性夜间遗尿症(PNE)儿童的感觉统合能力,探讨感觉统合失调在原发性遗尿症发生中的作用。方法：采用感觉统合能力发展量表对46例PNE组儿童及46例正常对照组儿童进行感觉统合功能测试,对两组结果采用t检验和χ2检验进行统计分析。结果：PNE组与对照组儿童感觉统合失调的发生率分别为82.6%和43.5%,其中重度失调的发生率分别为36.9%和2.1%,两组间差异有显著性（P﹤0.01）;PNE组所有感觉统合功能因子得分均明显低于对照组,差异有显著性(P﹤0.01)。结论：PNE组儿童存在感觉统合失调现象,感觉统合功能失调在PNE发生中可能有一定作用。     

原发性遗尿症儿童感觉统合能力的对照研究

目的：探索儿童原发性夜间遗尿症（PNE）与感觉统合能力的关系。方法：采用儿童感觉统合能力发展量表,对70例PNE患儿进行感觉统合功能测试,并与74例正常儿童进行对照研究。结果：PNE组感觉统合失调发生率 (76% vs 35%)、重度感觉统合失调发生率(39% vs 18%) 明显高于对照组,差异有统计学意义（P<0.01）。PNE组儿童所有感觉统合功能因子得分均明显低于对照组,差异有统计学意义（P<0.01）。结论：PNE患儿普遍存在感觉统合失调,并且是多方面的,故对PNE患儿进行感觉统合功能测试,并针对性地对伴发的感觉统合失调问题进行训练很有必要。［中国当代儿科杂志,2010,12（5）：341-343］     

儿童脑脓肿37例临床特征和治疗随访

目的 阐明儿童脑脓肿临床特征,探讨脑脓肿的治疗方法。方法 对３７例经ＣＴ和ＭＲＩ确诊为脑逐月中的患儿临床特征进行分析,对疗效进行观察,对其中２３例进行病后３个月～５年的随访。结果 ３７例患儿中未查到原发感染灶的２９例（７８％）,以癫痫为首发症状者２０例（５４％）,头痛者１８例（４９％）,发热者１３例（３５％）,３０例经保守治疗１１例治愈,１２例好转,总有效率７７％;７例采取外科治疗,１例治愈,３例     

儿童姿势性蛋白尿预后的远期随访和治疗分析

目的　探讨姿势性蛋白尿的远期预后、转归及治疗效果。方法　对 116例本病患儿尿蛋白的自然消失时间、转归、治疗效果进行了 5～ 18年的随访。对症状持续存在达 5年以上者进行肾活检检查 ,并分别给予泼尼松 ,泼尼松与环磷酰胺 (CTX)联合治疗。结果　 116例患儿中伴持续性蛋白尿者 17例 (肾功能减退 3例 ) ,间歇性蛋白尿伴发作性血尿 6例。对 2 1例症状未消失者肾活检结果示 :微小病变性肾炎 3例 ,系膜增生性肾炎 3例 ,局灶硬化 1例 ,无明显异常 14例 ;此 2 1例给予药物治疗后随访 2～ 5年 ,症状消失无复发 5例 ,偶有发作 4例 ,尿蛋白较前减少 3例。结论　本病大多数预后良好 ,症状消失数年无复发。但仍有 19 8%患儿发展为持续性蛋白尿、血尿及肾功能损害 ,对此应给予治疗     

Treatment and follow-up of children with cerebrotendinous xanthomatosis

The clinical spectrum and the effects of treatment over a period of 5 years in five children with cerebrotendinous xanthomatosis (CTX) are described. In all children biochemical, neuroradiological, and neurophysiological studies were done. CTX was diagnosed and effects of therapy were evaluated by determination of the serum cholestanol/cholesterol ratio (CCR) and the urinary excretion of bile alcohols. All children were treated with chenodeoxycholic acid (15 mg/kg/day) in three divided oral doses. Diarrhoea and juvenile cataract were the main clinical features. Psychomotor retardation, pyramidal and cerebellar signs were also found. After starting treatment, biochemical abnormalities normalized and diarrhoea disappeared. After 1 year of therapy there was no further delay in motor development, and in three children the intelligence quotient improved. EEG abnormalities disappeared. After 5 years of therapy the children are in a stable clinical condition. Conclusion The clinical, biochemical and neurophysiological abnormalities in five children with CTX showed a remarkable improvement after starting treatment with chenodeoxycholic acid. The early diagnosis of CTX and the start of treatment with chenodeoxycholic acid has prevented neurological deterioration for a period of 5 years. Received: 24 May 1997 / Accepted in revised form: 29 September 1997     

自体外周血造血干细胞移植患儿的远期随访

为探讨自体外周血造血干细胞移植（Ａｕｔｏ－ＰＢＳＣＴ）预处理的远期毒副作用，对８例Ａｕｔｏ－ＰＢＳＣＴ术后生存４～８年的恶性肿瘤患儿进行了随访。结果，８例患儿生长发育、神经精神发育、肾上腺皮质功能及免疫功能均正常。７例患儿甲状腺功能正常，１例发生代偿性甲状腺功能低下。５例进入青春期的患儿中４例性腺功能基本正常，１例男性性腺发育迟缓（伴有继发性血色病）。发现轻度白内障５例。５例丙型肝炎抗体阳性，其中４例肝功能异常，１例患乙型肝炎。提示，恰当的预处理方案对患儿远期生长发育、神经精神系统、内分泌、免疫系统无影响或影响较小，但轻度白内障发生率高，乙型肝炎、丙型肝炎在其治疗过程中的预防应引起重视。     

Development of very low birth weight infants: A regional study of 371 survivors

We re-examined 371 infants with birth weights less than 1501 g at a corrected age of 18–20 months. This sample amounted to 91% of such infants admitted to one of the six neonatal intensive care units in Hamburg between July 1983 and 1986. The neurological examination and a developmental evaluation using the Griffith Developmental Scale revealed higher rates of abnormalities than in most other studies. Fifty-five children (14.8%) suffered from cerebral palsy, classified in 45 as spastic diplegia, in 5 as spastic tetraplegia, in 1 as spastic hemiplegia and in 4 as dystonia. Of the children, 41 (11%) showed minor neurological deviations (hyperactivity, clumsiness, intention tremor). The development of 30 children (8%) without neurological abnormalities was moderately retarded (DQ 80-89, corrected for gestational age [GA]). Nineteen children (5%) were severely retarded (DQ<80, corrected for GA) and four children (1.5%) were blind due to retrolental fibroplasia. An isolated delay of speech development was found in 5 children. Seventy children (18.9%) had a major and 87 children (23.5%) a minor handicap.     

新生儿红斑狼疮12例临床特征和远期随访

目的 探讨新生儿红斑狼疮(Neonatal lupus erythematosus NLE)的发病机制、血清学改变、临床特征及远期预后。方法 确定NLE的条件：① 新生儿先天性心脏传导阻滞和新生儿或母亲的抗SSA/Ro、抗SSB/La抗体阳性;② 确定的和NLE相关的皮肤损害和新生儿或母亲的抗-Ro/SSA, 抗-La/SSB,或 抗-U1RNP抗体阳性。总结分析12例NLE患儿和母亲的临床表现,检测母亲和患儿的自身抗体,进行长期随访。并进行文献复习。结果 12例NLE , 男7例, 女5例, 就诊年龄1个月～5个月,起病年龄生后1d ～2个月,皮肤损害12例,血液学改变11例,肝脏受损6例,心脏受损4例,抗核抗体阳性12例,抗SSA/Ro抗 体阳性12例,抗SSB/La抗体阳性5例,抗ds-DNA抗体阳性4例,抗ENA抗体阳性4例,血沉增快6 例,血清丙氨酸转氨酶增高6例。12例母亲中孕前11例无症状,1例日光性皮炎;孕3～5个月时7例母亲出现日光性皮炎;2例发热、脱发、全血细胞减少;产后1个月 2例母亲出现皮疹、脱发;抗核抗体阳性12例,抗SSA/Ro抗体阳性12例,抗 SSB/La抗体阳性 5例,抗ds-DNA抗体阳性4例,抗ENA抗体阳性4例;血沉增快5例。12例NLE中11例随访18个月～12年,心电图完全右束支传导阻滞1例死亡。11例皮疹于3~11个月龄消退,自身抗体于6~12个月龄转阴,血液学改变、肝脏损害恢复正常,智力发育同正常同龄儿。1例3岁确诊为幼年特发性关节炎少关节炎型,1例12岁时出现反复颜面红斑皮疹,ANA阳性1：320,抗ds-DNA抗体阴性。12 例母亲中10例确诊为SLE,2例确诊为SS。结论 NLE是获得性的自身免疫疾病,临床表现主要有短暂性皮肤狼疮损害、先天性心脏传导阻滞、血细胞减少、黄疸、肝功能损伤等,肾脏受损少见。抗Ro (特别是抗-52KD SSA/Ro) 或抗-La抗体阳性的母亲是NLE的危险因素。NLE患儿需要长期随访,这些患儿存在到儿童期发展为其他自身免疫病的危险。     

Follow-up studies of very low birthweight children in Sweden

Follow‐up studies are essential to our knowledge of outcome in very low birthweight (VLBW) or extremely preterm (EPT) infants because those children have a greater risk for developing neurosensory disabilities and behavioural and educational problems and have decreased probability for an optimal transition into adulthood compared to term controls. Outcome data are of interest not only to healthcare professionals but also to parents, schoolteachers and society. The aim of this review is to describe the follow‐up studies of seven populations of VLBW or EPT infants performed in Sweden and published between 1995 and 2009. Conclusion: The time has come to implement evident data from these Swedish follow‐up studies into clinical practice and to perform regular and specific follow‐up examinations during childhood for all VLBW and EPT children. These assessments, specially designed for high‐risk infants, should consider the potential outcomes for neurological, visual, auditory function and cognitive function as well as behaviour and growth, from birth to school‐start.     

Mucopolysaccharidosis type III (Sanfilippo disease) in Sweden: clinical presentation of 22 children diagnosed during a 30‐year period

Aim: The aim of this study was to present the natural clinical course in children and adolescents with MPS III diagnosed during a 30‐year period in Sweden. Methods: The patients were identified from metabolic laboratory records between 1975 and 2004. Patient data were assessed from interviews of parents and by clinical examination and records from the patients. Results: A total of 15 children, 68%, with MPS IIIA were diagnosed at a median age of 6.8 years (range 1.2–18.9 years). One boy had MPS IIIB and five children MPS IIIC, diagnosed at ages between 1.9 and 11.6 years. In one child the type was not determined. The median age of children with type IIIA who had deceased was 16.2 years (range 10.4–31.2 years). Ten individuals with MPS III are alive at ages between 5 and 29 years. In four families, two children were affected. Conclusion: In 22 Swedish children with Sanfilippo disease an early normal development followed by a delay in speech and an appearance of behaviour problems was found in most children during the early preschool period. Mental retardation was diagnosed in almost all individuals before starting school. Early diagnosis is important in this devastating, progressive disorder, not only for genetic counselling but also for participation in future treatments.     

歪嘴哭面容新生儿的临床特征及随访研究

目的：评估歪嘴哭面容新生儿的临床特征及近期转归,为临床医师更深刻地认识该疾病提供信息。方法：回顾性研究2010年1月至2012年2月间收治的11例歪嘴哭面容患儿的临床特点,随访纠正胎龄44周和3月龄时的体格及神经发育情况。结果：11例歪嘴哭面容患儿中,4例合并同侧耳部发育异常,2例先天性心脏病,1例多指和并指畸形。男性8例,女性3例。8例病变为左侧,3例为右侧。父亲年龄超过35岁者8例,母亲年龄超过30岁者7例;多次妊娠者8例,不良孕产史者4例,母亲妊娠期糖尿病者2例。纠正胎龄44周时1例体格发育指标在同胎龄同性别的P10以下,2例NBNA评分小于35分,2例GMs评估扭动阶段为单调（轻度异常）;生后3月时11例患儿体格发育指标均在P10~P90之间,GMs评估不安运动阶段均正常,但歪嘴哭面容均无改善。结论：歪嘴哭面容患儿易合并其他畸形;患儿预后相对较好,但仍需长期随访,适时给予多学科合作干预。     

Quality of life in infants with atopic dermatitis and healthy infants: a follow-up from birth to 24 months

Aim: To evaluate quality of life (QOL) in infants with atopic dermatitis (AD) by comparison with healthy infants to find treatment modalities contributing most to QOL in these patients. Methods: The population (N = 134) was recruited in the context of an on‐going prospective mother–infant study. QOL was measured using the Infant Dermatitis Quality of Life Index for the infants with AD and a modification of this for the healthy infants. Results: The index scores of infants with AD were 4.15 (SD 2.96), 3.89 (SD 3.62) and 3.23 (SD 2.71) at 6, 12 and 24 months, respectively, the QOL being significantly poorer at 6 (p < 0.001) and 12 (p = 0.01) months compared to healthy infants. The principal impairments were itching, scratching and sleep disturbances at 6 and 12 months and treatment difficulties at 6 months. Problems with getting to sleep were reported at all stages irrespective of AD. Conclusions: Simple treatment regimens targeting itching in particular are likely to contribute most to the QOL of infants with AD; however, sleeping problems may remain as an age‐related phenomenon. Early detection of symptoms and effective parent guidance contributed to the well‐being of the child.