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标题: 高压氧与自闭症 [打印本页]

作者: 石头    时间: 2009-3-14 13:38
标题: 高压氧与自闭症
Oxygen therapy benefit in autism   
  
Autism is more often diagnosed in boys
A decompression chamber may help children with autism, say researchers.

After 40 hours of hyperbaric treatment autistic children showed significant improvements in social interaction and eye contact compared with controls.

The BMC Pediatrics study could not show if the results were long-lasting but should prompt further investigation of the treatment, the US team said.

One theory is that oxygen can help reduce inflammation and improve flow of oxygen to brain tissue.

Hyperbaric treatment - effectively giving high concentrations of oxygen at increased atmospheric pressure - has been shown to have some benefit in other neurological conditions such as foetal alcohol syndrome and cerebral palsy.

Some studies have looked at the treatment in children with autism but they have not compared with a dummy procedure raising questions around a "placebo effect".

In the latest study, carried out at six centres in the US, 62 children aged two to seven with autism were randomly assigned to receive 40 hours of treatment over a month with 24% oxygen at increased atmospheric pressure (1.3 atm) or normal air in a slightly pressurised room (1.03 atm).

Children who received the treatment showed significant improvements in overall functioning, receptive language, social interaction, eye contact, and sensory or cognitive awareness.

In all, 30% in the treatment group were rated by doctors as "very much improved" or "much improved" compared with 8% of those in the control group.

Overall, 80% in the treatment group improved compared with 38% of controls.

Behaviour

Study leader, Dr Dan Rossignol from the International Child Development Resource Centre, in Florida, said the use of hyperbaric therapy for autism has been gaining popularity in the US where parents can buy their own hyperbaric chamber if they have a spare $14-17,000.

He said the findings would be quite controversial and he too was initially very sceptical of the idea but was prompted to do more research after the treatment showed benefits for his two sons who have autism.

"We're certainly not talking about a cure, we're talking about improvements in behaviour, improving certain functions and quality of life.

"The next step is to try to find out which kids do respond, because it's an expensive treatment - it may be that kids with more inflammation respond better.

"It would also be nice to know how long the treatment lasts, and the finding needs to be confirmed."

Richard Mills, research director at Research Autism, said this was the first well-designed study looking at the therapy.

"We know this kind of therapy is useful in a number of neurological conditions and that's been well established.

"What we don't know is how useful it is in autism, what we could be seeing is an improvement in other neurological conditions that go alongside autism.

"We also don't know about long-term effects - it could be a transitory effect."

Professor Philip James, an expert in hyperbaric medicine at the University of Dundee, said the pressure used was no more than that used to pressurise an aircraft cabin on the ground.

He added that oxygen was the "controller of inflammation" but also had other effects on regulation of genes and tissue regeneration.

But even if proven, the treatment may not be for everybody.

"When you have any condition, there are people who have too much damage to get better."

"All the oxygen is doing is bringing things towards normal."


这篇报道是我从英国广播公司贴下来的,内容主要是讲氧气疗法对自闭症的好处。大致内容是这样:自闭症孩子在一个月内做上40个小时的高压氧舱后,社会性、语言性以及认知性都有了非常好的改善,但是这种疗法长不长久现在正在研究当中,至少氧气疗法可以遏制发炎并且增加氧气在脑中的流通量,甚至还能调节基因和帮助重建细胞。氧气治疗可能能把孩子们早点带入正常社会。这个高压氧舱有自己在家用的,但是非常贵,事先一定要计划好。
  

作者: blackeye    时间: 2009-3-14 18:00
标题: re:石头:你英文这么好,到译言里来参加‘孤独...
石头:你英文这么好,到译言里来参加‘孤独症’小组好不好?这里没有压力,没有时间限制,来去自由,很多在校生都在那里练英文呢。我相信不会影响你的学业的。当然先要争得你爸爸妈妈的同意。
作者: 石头    时间: 2009-3-14 19:15
标题: re:阿姨:我不明白“译言”是什么意思?你能否...
阿姨:我不明白“译言”是什么意思?你能否告诉我?
作者: 活动家    时间: 2009-3-14 19:23
标题: re:谢谢石头,
谢谢石头,
作者: blackeye    时间: 2009-3-14 19:56
标题: re:石头:译言是一个网站,你可以去看看。...
石头:译言是一个网站,你可以去看看。

http://www.yeeyan.com/

这是译言里的孤独症小组,专门翻译有关孤独症的文章。

http://www.yeeyan.com/groups/show/Autism

我知道你妈妈对你要求严格,可能不希望你泡在网上时间太长。在译言一切都是自愿的自由的,你可以注册但只读不翻译,注册以后你可以推荐你在英文网站发现的好文章,有的人就会认领,然后把它翻译出来。你也可以选择你喜欢的文章来翻译,然后发表在译言上。没有人会催你,你可以有空就翻没空就放在那里。

译言里的翻译水平参差不齐,但是大家可以互相挑错,互相帮助。在译言翻译文章没有报酬,大家都是志愿者,也没有门槛,谁都可以发表译作。那里有一些很不错的文章,但是也有垃圾,我相信你能分辨。

你不一定注册,先去看看,如果喜欢再注册。不过阿姨非常欢迎你来孤独症小组,你不一定翻译,你可以推荐你看到的有关孤独症的好文章到小组里来,有人会翻的。
作者: 佳佳爸爸    时间: 2009-6-4 16:03
标题: re:已经实验了26天,感觉没有效果.
    已经实验了26天,感觉没有效果.
作者: 维尼爱妈妈    时间: 2009-6-6 06:14
标题: re:这是一个长期的过程,短期可能看不到效果。...
这是一个长期的过程,短期可能看不到效果。3岁以前的孩子会比较明显。而且孩子应该和缺氧有关系,越小越好。
作者: 顽童    时间: 2009-6-6 19:43
标题: re:我觉得这个也要看每个小朋友的状况的,不一...
我觉得这个也要看每个小朋友的状况的,不一定适合每个小朋友的。
就像有很多人说听统的效果好,但我见过的几位小朋友效果均不明显,我觉得家长们在这些治疗面前应该慎重考虑。当然,也有一部分的也会有效果的。
作者: 维尼爱妈妈    时间: 2009-6-6 21:26
标题: re:高压氧疗对婴幼儿脑损伤神经系统后遗症的干...
高压氧疗对婴幼儿脑损伤神经系统后遗症的干预
开封市儿童医院   2008-12-10 08:28:01 作者:SystemMaster 来源: 文字大小:[大][中][小]
新生儿窒息、早产以及神经系统感染性疾病等是造成婴儿脑损伤的最常见原因。脑损伤后常遗留运动功能落后,运动姿势异常和(或)智力低下等神经系统后遗症,根据其临床表现症状体征的轻重程度,通常可发育迟缓、中枢性协调障碍、脑瘫。以往认为受损的神经组织不能再生,损坏了就不能恢复,脑瘫是不治之症,家长和医生对此类患儿常采取顺其自然、听之任之的态度,使患儿错过了康复的良机,最终发展为残疾人,给患儿造成终生的痛苦,给家庭、社会带来了沉重的负担。近年来,越来越多的学者通过多项研究提出了神经细胞凋亡和婴幼儿未成熟脑的新理论,认为早期的干预治疗可阻断神经细胞的凋亡,可促使受损伤的大脑细胞得以修复,并在不断成熟和分化的过程中功能得到较为有效的代偿。干预治疗的方法包括药物、多感观刺激、PT、OT、ST、高压氧疗、中医中药等,相互配合、相辅相成,可有效的改善脑损伤儿童的神经系统后遗症,提高儿童的生存质量和人口素质。

我院于2000年在全市率先引进开展高压氧治疗技术,尤其在近两年开展较好,先后完成了45例约1250次进舱治疗,对早产儿、窒息复苏后等高危儿在预防神经系统后遗症方面显示了理想的效果,对脑瘫儿动作发育的提高,异常姿势的消除也有较好的作用。

    1  临床资料

    1.1  一般资料  共进舱治疗45例约1250次,有较详细记录的36例,每一疗程为10天,完成1疗程5例(13.89%),2个疗程5例(13.89%),3个疗程24例(66.67%),2例未坚持满一疗程不列入疗效统计;年龄最大3岁,最小11天;基础疾病:新生儿窒息(30例),早产儿(3例),脑炎(1例),脑积水(2例),吸入性肺炎(1例),先心病(1例),不详(1例);治疗前诊断:脑瘫15例,发育迟缓9例,窒息儿无症状早期干预10例;脑瘫组平均年龄1316   30月,发育迟缓组平均年龄220   30月,无症状干预组平均年龄1310   30月。

    1.2  疗效判定标准  显效:完成最后一次治疗后检查,异常姿势消除,运动发育基本达同龄儿正常水平;有效:完成最后一次治疗后检查,原症状体征有较好的改善,运动发育有进步,但未达到同年龄正常儿水平;无效:完成最后一次治疗后检查,症状体征改善不明显,动作发育无进步。

    1.3  疗效统计  显效7例(20.59%),有效23例(67.65%),无效4例(11.76%),总有效率88.24%。

    1.4  统计图表  疗效与疗程的关系见表1;疗效与干预治疗开始年龄的关系见表2。表1  疗程与疗效的关系表2  疗效与干预治疗开始年龄的关系

2  讨论

    高压氧医学是一门新兴的临床学科,治疗的适应证涉及内、外、妇儿、神经、五官、传染等多个学科。1963年Hutchinson报道首例高压氧治疗抢救新生儿窒息获得成功。近30年我国高压氧医学在临床治疗中取得了极为丰富的实践经验,对婴幼儿脑损伤后神经系统后遗症的预防和干预就是儿科发展中的新技术、新成果,高压氧治疗是通过增加血氧含量,提高氧分压,扩大血氧弥散范围,改善脑组织缺氧状态,有利于脑细胞的正常代谢,促进受损脑细胞的修复和脑功能恢复从而达到避免和减轻神经系统的后遗症。国内毛云鹏等1992年报道6年内高压氧治疗小儿脑瘫1170例,年龄最小的30天,最大的13岁,痊愈630例(53.8%),有效448例(38.3%),无效92例(7%),总有效率92.1%;湖南医科大学报道12年内高压氧治疗小儿脑瘫432例,多为1~3岁患儿,显效179例,有效194例,无效59例,总有效率86.5%,我院观察记录的34例总有效率为87.9%,与上述两家基本相符。笔者的体会有三点:(1)高压氧在提高颈、腰及四肢运动系统的肌力、改善斜视方面效果突出,对部分患儿在智力和语言功能方面也有一定提高;(2)从表1、表2中可发现在一定范围内疗效与疗程呈正相关。疗效与干预治疗开始的年龄呈负相关。尤其是本组10例窒息新生儿在无症状情况下早期干预2~3个疗程结束后检查全部达到同年龄正常儿动作发育水平,令人鼓舞。验证了早期干预的必要性和未成熟脑可塑性强,具有变通性和代偿性功能的新观点;(3)要严格掌握适应证、禁忌证,严格遵守操作规程、各年龄段的吸氧时间和压力范围以及操作注意事项,尤其应该提出的是在活动性出血未止的儿童和小于32孕周的新生儿、极低体重儿禁忌,高压氧的眼毒副作用就主要发生于高压、超长时间用氧的未成熟儿,一旦发生,可导致视网膜功能障碍甚至失明,但对一般婴儿绝非严重。日本、美国将新生儿列为禁忌,国内只限制小于34周的新生儿、极低体重儿,我科除在早期有3例于新生儿期内开始接受治疗外,以后全都改为满月后开始治疗,以尽可能的规避风险。总之,高压氧疗是有效的干预治疗新方法,且社会效益与经济效益并存,值得推广应用。在我科治疗的34例患儿中,无高压氧治疗的毒副作用发生。






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