由于自闭症为慢性疾病,如果不及早实施治疗,约2/3患儿预后不良,成年后无法独立生活,仍需要家庭养护,给家庭和社会增加严重负担。为了改善自闭症预后,及早发现并进行长期的综合训练,有望根本改善;细胞治疗又给自闭症患儿增添有价值的治疗途径,但要把握好自闭症的适应证和禁忌证等,促进自闭症早日康复。
(1)适应证:①自闭证实施综合训练6个月,症状无明显改善者;②自闭症不能接受综合训练者;③希望增加细胞治疗提高治疗效果者;④有明确的围生期损害史的自闭症者;⑤伴有脑发育不良的自闭症者等。
(2)禁忌证:除总体细胞治疗禁忌证外(细胞治疗的总体禁忌证请参阅第一章细胞治疗相关知识16题),加上自闭症的禁忌证:有明显的遗传病因素,如双胎均患自闭症、有染色体异常的自闭症。
(3)实施后康复治疗:实施细胞治疗后需要进行强化综合训练,如强化感觉统合训练、强化语言训练、日常生活中的自我服务能力训练和有意识的社会交往训练等,以促进多种感觉信号输入,增强脑细胞间有效信息通路(突触连接)建立,既可提高细胞治疗自闭症的效果,又加强自闭症综合治疗效果,使自闭症获得最佳预后。
参考文献
[1] 袁广兰,李茂勇.儿童孤独症的诊治进展[J].基层医学论坛,2006,10(8):741.
[2] Lauritsen M,Ewald H.The genetics of autism [J].Acta Psychiatr Scand,2001,103:411.
[3] 邹小兵.儿童心理行为及其发育障碍[J].中国实用儿科杂志,2002,17(6):380.
[4] 陶国泰.儿童少年精神医学[M].南京:江苏科学技术出版社,1999:207.
[5] Singh VK,Warren RP,Odell JD,et al.Antibodies to myelin basic protein in children with autistic behavior[J].Brain Behav Immun,2008,7:97.
[6] Silva SC,Correia C,FeseI C,et al.Autoantibody repertoires to brain tissue in autism nuclear families[J].J NeuroimmunoI,2008,152:176.
[7] Singer HS,Morris CM,Williams PN,et al.Antibrain antibodies in children with autism and their unafiected siblings[J].J NeuroimmunoI,2007,178:149.
[8] Vojdani A,O’Bryan Green JA,et al.Immune response to dietary proteins,gliadin and cerebellar peptides in children with autism[J].Nutr Neurosci,2008,7:151.
[9] Sweeten TL,Bowyer SL,Posey DJ,et al.Increased prevalence of familial autoim munity in probands with pervasive developmental disorders[J].Pediatrics,2008,112:420.
[10] 李雪荣.广泛性发育障碍——现代儿童精神病学[M].长沙:湖南科学技术出版社,1994:174.
[11] 杨惠芳.103例儿童孤独症的临床脑电图分析[J].中原医刊,2005,32(8):22.
[12] MitchelI S,Bdan J,Zwaigenbaum L,et al.Early Ianguage and communication development of infants later diagnosed with autism spectrum disorder[J].J Dev Behav Pediatr,2007,27:S69.
[13] Mukaddes NM,Kaynak FN,Kinali G,et al.Psychoeducational treatment of children with autism and reactive attachment disorder[J].Autism,2004,8(1):101.
[14] Butter EM,Wynn J,Mulick JA.Early intervention critical to autism treatment[J].Pediatr Ann,2003,32(10):677.
[15] 李建华,钟建军,蔡兰云,等.三种儿童孤独症行为评定量化表临床应用比较[J].中国当代儿科杂志,2005,7(1):60.
[16] 张作记.行为医学量表手册[M].北京:中华医学电子音像出版社,2005:470.
[17] 高玉玲,田百玲,严颖.儿童孤独症的治疗[J].实用药物与临床,2005,8(2):42.
[18] 刘药斐.儿童孤独症及其行为疗[J].合肥学院学报,2005,22(4):136.
[19] 王莉萍,卢正和,张俊青,等.儿童孤独症行为训练效果分析[J].中国行为医学科学,2004,13(6):645.
[20] 侯加平,孙毅平,胡翠玲.120例孤独症儿童临床调查分析[J].中国妇幼保健,2006,21:1264.
[21] 张焱.音乐治疗干预高功能孤独症儿童行为训练的个案研究[J].中国特殊教育,2005,62(8):38.
[22] 刘靖.听觉统合治疗疗效的初步分析[J].孤独症儿童康复动态汇编,1998:119-120.
[23] Walworth DD.The use of music therapy within the SCERTS model for children with Autism Spectrum Disorder[J].J Music Ther,2007,44(1):2.
[24] Kern P,Aldridge D.Using embedded music therapy interventions to support outdoor play of young children with autism in an inclusive community-based child care program[J].J Music Ther,2006,43(4):270.
免责声明:以上内容源自网络,版权归原作者所有,如有侵犯您的原创版权请告知,我们将尽快删除相关内容。