儿童孤独症116例诊治探讨

Clinical analysis of on the diagnosis and treatment of 116 children with autism

目的 :探讨孤独症的病因、诊断、训练方法和治疗效果。方法 :对 116例孤独症病例进行生物学因素 (妊娠史、出生史、家族史、抽搐史 )、家庭因素 (父母性格、家庭教育方式 )、病历主诉、发病年龄、确诊年龄、辅助检查 (脑 CT、 EEG、BAEP和 SPECT)做统计分析。结果 :儿童孤独症在生物学因素中存在较普遍的异常 ,尤其是父亲内向的性格特点突出。病历主诉以语言障碍和交流障碍为主 ,脑部 CT、 EEG、 BAEP和 SPECT辅助检查中 ,SPECT异常检出率高 ,主要表现为大脑局灶性血流灌注量降低。该组病例确诊年龄晚于发病年龄 2 9个月 ,多学科参与的结构化教育、感觉统合训练、语言训练和听觉统合训练是治疗孤独症儿童的有效方法 ,年龄越小、训练强度越大、训练时间越长越连续效果越好。结论 :异常妊娠史、出生史、家族史和父亲内向的性格特点与孤独症发病有密切关系 ;临床易误诊 ,以语言发育迟缓伴非言语性交流障碍为主诉的儿童应考虑孤独症的可能 ;多学科参与的综合训练是治疗孤独症的有效方法。

Objective:To explore the pathogenesis, diagnosis , the training methods and treatment result of autism.Methods:116 cases of autism children were studied by statistical analysis about biologic factors (pregnancy,birth,family,seizure),family factors(parents' character, family education method),chief complaint,pathogenic age,diagnosis age and assistant examinations(CT,EEG,BAEP,SPECT,meanwhile to make a conclusion on the training methods and treatment result.Results:The abnormality in biologic factors was generally seen among the autism children,the inner-character of fathers were obvious seen.Among the assistant examinations,especially an high abnormality was found in SPECT.Diagnostic age is later than the pathogenic age for 29 months.The treatment and education of autistic and related communication handicapped children(TECCH),sensory integration therapy,language therapy and audio integration therapy are effective methods on treating the autism.The more small the age is,and intensive the training is,and long the training is,the more effective the treatment is.Conclusion:There was relationship between the abnormality of pregnancy,birth,family, father's inner-character and the pathogenesis of autism,and easy to delay the correct diagnosis. The probability of autism should be paid attention when the language development disability with communication disability.The complex training with several subjects is the effective method on treating the autism.