孩子都是父母的宝贝，孩子生病了，一家人都很心疼，特别有的需要手术，看着哭泣的宝贝，父母的眼睛👀中也噙满了泪水。家长除了心疼宝贝受着病痛的折磨，也担心麻醉对智力的影响，毕竟婴幼儿时期是大脑发育的黄金期。到目前为止，这方面还没有确切的结论，麻醉对大脑的发育是否产生不良后果还存在争议。这篇发表在Pediatr Res. 的文章Surgery requiring general anesthesia in preterm infants is associated with altered brain volumes at term equivalent age and neurodevelopmental impairment考察了全麻手术对早产儿大脑发育的影响，其结果如何呢？
Surgery requiring general anesthesia in preterm infants is associated with altered brain volumes at term equivalent age and neurodevelopmental impairment
Background: The aim of the study was to describe and contrast the brain development and outcome among very preterm infants that were and were not exposed to surgery requiring general anesthesia prior to term equivalent age (TEA).
Methods: Preterm infants born ≤30 weeks' gestation who did (n = 25) and did not (n = 59) have surgery requiring general anesthesia during the preterm period were studied. At TEA, infants had MRI scans performed with measures of brain tissue volumes, cortical surface area, Gyrification Index, and white matter microstructure. Neurodevelopmental follow-up with the Bayley Scales of Infant and Toddler Development, Third Edition was undertaken at 2 years of corrected age. Multivariate models, adjusted for clinical and social risk factors, were used to compare the groups.
Results: After controlling for clinical and social variables, preterm infants exposed to surgical anesthesia demonstrated decreased relative white matter volumes at TEA and lower cognitive and motor composite scores at 2-year follow-up. Those with longer surgical exposure demonstrated the greatest decrease in white matter volumes and lower cognitive and motor outcomes at age 2 years.
Conclusions: Very preterm infants who required surgery during the preterm period had lower white mater volumes at TEA and worse neurodevelopmental outcome at age 2 years.
Impact: In very preterm infants, there is an association between surgery requiring general anesthesia during the preterm period and reduced white mater volume on MRI at TEA and lower cognitive and motor composite scores at age 2 years.It is known that the very preterm infant's brain undergoes rapid growth during the period corresponding to the third trimester.The current study suggests an association between surgery requiring general anesthesia during this period and worse outcomes.
Walsh BH, Paul RA, Inder TE, Shimony JS, Smyser CD, Rogers CE. Surgery requiring general anesthesia in preterm infants is associated with altered brain volumes at term equivalent age and neurodevelopmental impairment [published online ahead of print, 2020 Jun 23]. Pediatr Res. 2020;10.1038/s41390-020-1030-3. doi:10.1038/s41390-020-1030-3
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