婴幼儿时期接受全身麻醉与手术对远期的智力和感觉统合能力发育的影响

摘要

Objective:To explore the long-term effects of general anesthesia and surgery on the development of intelligence and sensory integration .Methods:According to the 1:1 matched case-control study ,the main fac-tors influencing the intellectual development of the children in the experimental group were as follows :age ,sex ,ed-ucational background .Weselected 6 to 8 years old child who underwent noncardiac and neurosurgical surgery under general anesthesia in 0-3 years old as the experimental group (n=79) .And The children aged 0-3 years who had not received general anesthesia and surgery were selected as the control group (n=79) .The intelligence and sensory in-tegration abilities of the two groups were evaluated by the Wechsler Children's Intelligence Scale and the School Age Sensory Integration Rating Scale .Results :In the intellectual development ,There were no significant differences in the indexes between the two groups (P>0 .05) .In the intellectual internal structure ,the difference of speech com-prehension-working memory index ,verbal comprehension-processing speed index ,perceived reasoning-processing speed index in experimental group was 26 .58% 、16 .46% 、20 .25% ,which were significantly higher than those of the control group (P<0 .05) .The incidence of vestibular dysfunction in the experimental group (25 .32% ) significantly higher than the control group(2 .53% ) (P<0 .05) .Conclusion:Infants and young children undergoing general anes-thesia and surgery on the long-term intelligence and sensory integration ability had no significant effect ,but which has an impact on vestibular function .And the difference of speech comprehension-working memory index ,verbal comprehension-processing speed index ,perceived reasoning-processing speed index was significantly different .%目的:探讨婴幼儿接受全身麻醉与手术对智力和感觉统合能力发育的远期影响.方法:选取在0~3岁时全身麻醉下进行过非心脏和神经外科手术的现6~8岁儿童作为本研究的实验组(n=79),根据1:1匹配病例对照研究,以实验组儿童的年龄,性别,教育背景,父母职业等影响智力发育的主要因素作为条件,选择在0~3岁未接受过全身麻醉与手术的儿童作为对照组(n=79),应用韦氏儿童智力量表,学龄儿童感觉统合评定量表评价两组患儿的智力和感觉统合能力.结果:在智力发育方面,两组儿童各项指数比较差异均无统计学意义(P>0.05);在智力内部结构方面,实验组的语言理解-工作记忆指数、言语理解-加工速度指数、知觉推理-加工速度指数的差值分别为26.58%、16.46%、20.25%,均明显高于对照组的发生率(P<0.05);实验组儿童前庭功能失调的发生率为25.32%,对照组为2.53%,两组比较差异具有统计学意义(P<0.05).结论:婴幼儿时期接受全身麻醉与手术对远期的智力和感觉统合能力无明显影响,但言语理解-工作记忆指数、言语理解-加工速度指数、知觉推理-加工速度指数的差值临床差异的发生率较高,且接受全麻手术后对前庭功能有影响.