导语：
近日，一项针对5岁前多次全身麻醉对孩子神经发育影响的研究引起了广泛关注。那么，多次全身麻醉究竟会不会对孩子的智力发展产生不良影响？让我们一起来看看这项研究结果。
摘要译文（供参考）
背景：
此前，GAS试验表明，对于接受单次全身麻醉（GA）进行选择性腹股沟疝手术的婴儿，在2岁和5岁时的大多数神经发育结果与未接受GA的婴儿相当。然而，试验中有超过20%的孩子在初次手术后至少接受了一次额外的麻醉。利用GAS数据库，本研究旨在探讨多次（2次或以上）GA暴露与早期童年单次或无GA暴露对孩子5岁时神经发育结果的影响。
方法：
研究人员从GAS数据库中筛选出多次GA暴露的孩子和单次或无GA暴露的孩子。主要观察指标是5岁时韦氏学前儿童智力量表第三版（WPPSI-III）的全量表智商（FSIQ）。次要观察指标包括针对所有主要发育领域的神经认知测试和评估情绪和行为问题的家长报告问卷。
结果：
共有90名多次GA暴露的孩子和141名单次或无GA暴露的孩子完成了评估。与单次或无GA暴露的孩子相比，多次暴露的孩子在WPPSI-III FSIQ平均得分低近6分（平均：-5.8，95%置信区间：-10.2至-1.4，p=0.011）。此外，他们在言语、操作智商得分较低，且在情绪、行为和执行功能方面存在更多困难。然而，由于本研究为观察性研究，无法排除显著的残余混杂因素。
结论：
5岁前多次GA暴露与孩子在一般智力得分和一些神经发育评估领域的表现下降有关。然而，鉴于样本量较小和未调整的残余混杂因素，我们的结果在临床意义上的解读必须谨慎。本研究也揭示了试验数据集在二次分析中可能不适合其目的的局限性。
结语：
虽然这项研究提示多次全身麻醉可能对孩子的神经发育产生一定影响，但家长朋友们不必过于担忧。在临床实践中，医生会根据孩子的具体情况权衡利弊，确保手术安全。同时，关注孩子的成长发育，及时进行神经发育评估，有助于早期发现和干预潜在问题。
原文摘要
Neurodevelopmental Outcomes After Multiple General Anaesthetic Exposure Before Five Years Of Age - A Cohort Study
Background: The GAS trial demonstrated evidence that most neurodevelopmental outcomes at 2 years and 5 years of age in infants who received a single general anaesthetic (GA) for elective inguinal herniorrhaphy were clinically equivalent when compared to infants who did not receive GA. More than 20% of the children in the trial had at least one subsequent anaesthetic exposure after their initial surgery. Using the GAS database, this study aimed to address whether multiple (2 or more) GA exposures compared to one or no GA exposure in early childhood were associated with worse neurodevelopmental outcomes at 5 years.
Methods: Children with multiple GA exposures and children with one or no GA exposure were identified from the GAS database. The primary outcome was the full-scale intelligence quotient (FSIQ) on the Wechsler Preschool and Primary Scale of Intelligence third edition (WPPSI-III) at 5 years of age. Secondary outcomes included neurocognitive tests addressing all major developmental domains and caregiver-reported questionnaires assessing emotional and behavioural problems.
Results: Complete assessment was available from a total of 90 children in the multiple GA group and 141 children in the 0 or 1 GA group. Compared with children with a single or no GA exposure, multiply exposed children scored on average almost 6 points lower (mean: -5.8, 95% CI: -10.2 to -1.4, p= 0.011) in WPPSI-III FSIQ. They also demonstrated lower verbal and performance IQ scores and more emotional, behavioural, and executive function difficulties. However, significant residual confounding cannot be excluded from the results due to the observational nature of this study.
Conclusions: Multiple GA exposure before 5 years of age was associated with reduced performance in general intelligence score and some domains of neurodevelopmental assessments. The clinical significance of our results must be cautiously interpreted in light of several sources of limitations including small sample size and unadjusted residual confounding. This study illustrates the limitations of trial data sets that may not be fit for the purpose for the secondary analysis.
注意：
上述内容仅供参考，以实际临床医疗为准！
