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《广州医药》编辑部
目的 探讨运动干预联合治疗性聆听对孤独症谱系障碍儿童社会交往功能的影响。方法 选取黄河三门峡医院2020年1月—2023年10月收治的100例孤独症患儿,应用随机数字表法分为两组,各50例。对照组患儿实施常规护理,观察组在对照组基础上增加运动干预联合治疗性聆听。分别在干预前及干预6个月后采用孤独症治疗评价量表(ATEC)、儿童感觉统合发展评定量表、格塞尔发育量表(GDS)及中国韦氏儿童智力量表(WISC-R)评价两组患儿社会交往能力、感觉统合发展水平、神经发育水平及智力水平变化。结果 干预后两组患儿的ATEC各部分评分,包括健康/生理/行为、感知/认知能力、社交能力、语言表达/沟通能力及ATEC总分均降低,观察组低于对照组(P<0.05);干预后两组患儿学习能力发展、本体感觉、触觉防御、前庭功能及儿童感觉统合发展评定量表总分均升高,观察组高于对照组(P<0.05);干预后两组患儿动作能、应物能、言语能、应人能相关神经发育情况评分均升高,观察组高于对照组(P<0.05);干预后两组患儿言语智商、操作智商、总智商相关WISC-R评分均升高,观察组高于对照组(P<0.05)。结论 运动干预联合治疗性聆听对孤独症谱系障碍儿童应用效果显著,可提升其社会交往能力,促进感觉统合发展,进而促进其神经发育及智力水平提升。
Objective To explore the effect of exercise intervention combined with therapeutic listening on social communication function in children with autism spectrum disorder.Methods A total of 100 autistic children who were admitted to our hospital from January 2020 to October 2023 were selected and divided into two groups by random number table method,with 50 children each.The control group received routine care,while the observation group received exercise intervention combined with therapeutic listening in addition to routine care.The Autism Treatment Evaluation Scale (ATEC),Children’s Sensory Integration Development Scale,Gesell Development Scale,and Wechsler Intelligence Scale for Children-Revised by China (WISC-R)were used before and 6 months after the intervention to evaluate the social communication ability,sensory integration development level,neural development level,and intellectual level changes of the two groups of children.Results After intervention,the score of every dimension in ATEC including the health/physiology/behavior,perception/cognitive ability,social ability,language expression/communication ability,and total ATEC score of the two groups of children decreased,and the observation group was lower than the control group (P<0.05).After intervention,the total scores of the learning ability development insufficient,proprioceptive dysfunction,excessive tactile defense,vestibular dysfunction,and children’s sensory integration development assessment scale in both groups of children increased,with the observation group being higher than the control group (P<0.05).After intervention,the neurological development scores related to motor,adapt,language,and social ability in both groups of children increased,and the observation group was higher than the control group (P<0.05).After intervention,the WISC-R scores related to verbal intelligence,operational intelligence,and total intelligence in both groups of children increased,and the observation group was higher than the control group (P<0.05).Conclusions The combination of exercise intervention and therapeutic listening has asignificant effect on children with autism spectrum disorder,which can enhance their social communication ability,promote sensory integration development,and ultimately promote their neural development and intellectual level improvement.
目的 探究支气管镜联合雾化吸入药物对肺炎支原体肺炎患儿症状持续时间及肺部影像学好转情况。方法 选取94例肺炎支原体肺炎患儿为研究对象,以随机数字表法分为A组、B组,各47例,分别实施布地奈德雾化吸入治疗、支气管镜肺泡灌洗联合布地奈德雾化吸入治疗,比较两组症状持续时间、治疗后肺部影像改善情况、炎症指标水平及不良反应发生率。结果 B组体温恢复时间(2.73±0.51)d、咳嗽消失时间(5.98±1.24)d、住院时间(10.96±3.36)d,A组分别为(3.14±0.83)(7.06±2.33)(13.27±3.18)d,B组较A组短(t=2.885、2.809、3.423,均P<0.05);治疗后B组40.43%阴影完全消失、34.04%阴影显著缩小、23.40%阴影有所缩小、2.13%阴影改善不明显,A组分别为21.28%、36.17%、25.53%、17.02%,B组肺部阴影改善情况优于A组(Z=8.311,P<0.05);治疗前B组白细胞计数(WBC)、超敏C-反应蛋白(hs-CRP)、降钙素原(PCT)水平与A组相近(P>0.05);治疗后B组WBC(7.71±1.94)×109 /L、hs-CRP(4.96±1.44)mg/L、PCT(84.32±21.40)pg/mL,A组分别为(9.05±2.48)×109 /L、(6.17±1.85)mg/L、(105.46±34.02)pg/mL,B组水平较A组低(t=2.918、3.538、3.606,均P<0.05);B组不良反应发生率为8.52%,A组为4.26%,B与A组相近(χ 2 =0.178,P>0.05)。结论 对肺炎支原体肺炎患儿实施支气管镜联合雾化吸入药物治疗,可缩短康复时间,促进肺部阴影消退,降低其炎症指标水平,且未增加不良反应发生率。
Objective To investigate the effect of bronchoscopy combined with nebulized inhalation of medication on the duration of symptoms and pulmonary imaging conversion in children with Mycoplasma pneumoniae pneumonia(MPP).Methods A total of 94 children with MPP were selected as the research subjects and randomly divided into Group A and Group B using a random number table,with 47 cases in each group.They were treated with budesonide nebulization inhalation therapy and bronchoalveolar lavage combined with budesonide nebulization inhalation therapy,respectively.The duration of symptoms,improvement of lung imaging before and after treatment,levels of inflammatory indicators,and incidence of adverse reactions were compared between the two groups.The results showed that the temperature recovery time was(2.73±0.51)days,cough disappearance time was(5.98±1.24)days,and hospitalization time was(10.96±3.36)days in Group B,(3.14±0.83)days,(7.06±2.33)days,and(13.27±3.18)days in Group A,respectively.Durpation in Group B was shorter than Group A(t=2.885,2.809,3.423,all P<0.05). After treatment,40.43% of the shadows in Group B completely disappeared,34.04% of the shadows significantly reduced,23.40% of the shadows reduced,and 2.13% of the shadows showed no significant improvement,better than 21.28%,36.17%,25.53%,and 17.02% in Group A(Z=8.311,P<0.05). Before treatment,the white blood cell count(WBC),high-sensitivity C-reactive protein(hs CRP),and procalcitonin(PCT)levels in group B were similar to those in Group A(P>0.05).After treatment,the WBC(7.71±1.94)×109 /L,hs CRP(4.96±1.44)mg/L,and PCT(84.32±21.40)pg/mL in Group B were lower than those in Group A(9.05±2.48)×109 /L,(6.17±1.85)mg/L,and(105.46±34.02)pg/mL,respectively(t=2.918,3.538,3.606,all P<0.05).The incidence of adverse reactions in Group B was 8.52%,while in Group A it was 4.26%.The incidence of adverse reactions in group B was similar to that in group A(χ 2 =0.178,P>0.05).Conclusions Bronchoscopy combined with nebulized inhalation therapy for children with MPP can shorten the recovery time,promote the disappearance of lung shadows,reduce their inflammatory index levels,and without increasing the incidence of adverse reactions.
目的 探讨眼底豹纹斑密度(FTD)及视盘旁萎缩弧(PPA)与眼轴长(AL)的相关性,为眼底定量化在儿童近视防控的应用提供科学依据。方法 本研究随机抽取广州市荔湾区两所小学三年级学生作为研究对象,在校园视力筛查的过程中同时采集AL、CR和眼底彩照。使用AI软件对眼底彩照进行量化分析,量化指标包括不同区域和范围的FTD及PPA面积大小,根据眼轴长度分为三组:A组(AL<23 mm);B组(23 mm≤AL<24 mm);C组(24 mm≤AL)。结果 共有398例右眼被纳入统计分析,年龄范围8~11岁,中位数是9岁,男性人数占55.1%。三组组间AL、AL/CR和SE比较均有统计学差异(P<0.05)。A组与B组相比,FTD在后极部整体范围、黄斑中心3 mm区域、黄斑中心3 mm区域上方区域具有统计学差异(P<0.05),C组与B组相比,PPA面积及FTD在后极部整体范围、视盘为中心4.5 mm范围、黄斑为中心直径3 mm和6 mm范围均具有统计学差异(P<0.05),Spearman相关性分析表明,AL与PPA(r=0.443)和FTD(r=0.322)呈正相关(P<0.001)。亚组相关性分析表明,A组仅黄斑为中心直径3 mm上方范围FTD与AL呈正相关(P=0.028),B组PPA、黄斑中心直径3 mm及其上方范围FTD与AL呈正相关(P<0.05),C组仅PPA与AL呈正相关(P=0.005)。结论 眼底定量对于儿童近视防控具有潜在价值,PPA和FTD与AL呈正相关性,不同区域和范围FTD与AL相关性具有一定差异性,黄斑中心直径3 mm范围及其上方范围与眼轴相关性最强。FTD在短眼轴阶段就可以作为生物标记物预测近视严重程度,而PPA主要在长眼轴阶段体现生物标记物的作用。
Objective To investigate the correlation between fundus tessellated density(FTD)and peripapillary atrophy(PPA)with axial length(AL), providing a scientific basis for the application of fundus quantification in the prevention and control of myopia in children. Methods This study randomly selected third-grade students from two primary schools in Liwan District, Guangzhou City, as research subjects. Axial length(AL), corneal radius(CR), and fundus color photographs were collected simultaneously during the school vision screening process. AI software was utilized to perform quantitative analysis on the fundus color photographs, with quantification indicators including the area size of PPA and FTD in different regions and ranges. Subjects were divided into three groups based on axial length:Group A(AL<23 mm); Group B(23 mm≤AL<24 mm); Group C(AL≥24 mm). Results A total of 398 right eyes were included in the statistical analysis, with an age range of 8 to 11, a median age of 9, and 55.1% were male. There were significant statistical differences in AL, AL/CR, and spherical equivalent(SE)among the three groups(P<0.05). Compared with Group B, Group A showed significant statistical differences in FTD in the overall posterior pole, the 3 mm diameter area centered on the fovea, and the superior area of the 3 mm foveal center(P<0.05). Compared with Group B, Group C showed significant differences in PPA area and FTD in the overall posterior pole, the 4.5 mm diameter area centered on the optic disc, and the 3 mm and 6 mm diameter areas centered on the fovea(P<0.05). Spearman correlation analysis indicated that AL was significantly positively correlated with PPA(r=0.443)and FTD(r=0.322)(P<0.001). Subgroup correlation analysis showed that in Group A, only the FTD in the superior area of the 3 mm diameter centered on the fovea was significantly positively correlated with AL(P=0.028). In Group B, PPA and FTD in the 3 mm diameter and superior area centered on the fovea were significantly positively correlated with AL(P<0.05). In Group C, only PPA was significantly positively correlated with AL(P=0.005). Conclusions Fundus quantification holds potential value for the prevention and control of myopia in children. PPA and FTD show significant positive correlations with AL, with varying degrees of correlation in different regions and ranges of FTD with AL. The 3 mm diameter area centered on the fovea and its superior area have the strongest correlation with the eye axis. FTD can serve as a biomarker to predict the severity of myopia in the early stages of eye axis elongation, while PPA primarily manifests as a biomarker in the later stages of elongation.