TERAPÖTİK HİPOTERMİ TEDAVİSİ ALAN ÇOCUKLARIN MOTOR GELİŞİM SONUÇLARI: EBEVEYN GÖRÜŞLERİ İLE BİRLİKTE

Amaç: Hipoksik iskemik ensefalopatili (HİE) bebeklerin nörogelişimsel takibi ve gelişimlerinin desteklenmesi yaşamlarının sonraki yılları için büyük önem taşımaktadır. Bu çalışmanın amacı, terapötik hipotermi (TH) tedavisi alan HİE’li çocukların motor gelişim sonuçlarını objektif bir değerlendirme yöntemi ve ebeveynlerin bakış açısıyla değerlendirmek ve bu iki değerlendirme yöntemini karşılaştırmaktır.Gereç ve Yöntem: TH tedavisi alan 22 HİE’li (11 kız, 11 erkek) olgu dahil edildi. Olguların 16’sı (%72,7) Sarnat Evre-2, 6’sı (%27,3) ise Sarnat Evre-3 olarak sınıflandırıldı. Olguların motor gelişimleri Bayley Bebek ve Küçük Çocuklar için Gelişim Ölçeği (Bayley-III) ile değerlendirildi. Ebeveynlerin çocuklarının gelişimi ile ilgili görüşleri Erken Gelişim Evreleri Anketi-2 (ASQ-2) ile incelendi.Bulgular: Bayley-III motor skalasına göre olguların %68,2’sinde (n=15) normal motor gelişim saptanırken; %18,2’sinde (n=4) hafif-orta motor gelişim geriliği ve %13.6’sında (n=3) şiddetli motor gelişim geriliği saptandı. Motor gelişimin alt alanlarına bakıldığında olguların %68,2’sinin (n=15) normal kaba motor gelişimi, %86,4’ünün (n=19) normal ince motor gelişimi olduğu görüldü. Öte yandan ASQ-2 sonuçlarına göre olguların %68,2’si (n=15) normal kaba motor ve ince motor gelişim gösterdiği görüldü.Sonuç: Objektif değerlendirme sonuçları ile ebeveyn görüşleri kaba motor gelişim açısından paralellik gösterse de ince motor gelişim açısından farklılık göstermektedir. Ancak ASQ-2, bir uzmana erişimin sınırlı veya zor olduğu durumlarda HİE’li çocukların takibinde yardımcı olabilir ve ayrıca ebeveynlerine çocuklarının gelişimi hakkında fikir verebilir.

Anahtar Kelimeler:

hipoksik iskemik ensefalopati, terapötik hipotermi, motor gelişim

MOTOR DEVELOPMENT OUTCOMES OF CHILDREN WHO HAVE UNDERGONE THERAPEUTIC HYPOTHERMIA: WITH PARENTS’ VIEWS

Objective: Neurodevelopmental follow-up of infants with hypoxic ischemic encephalopathy (HIE) and supporting their development have great importance for the later years of their life. The aim of this study was to evaluate motor development outcomes of children with HIE who have undergone therapeutic hypothermia (TH) in Turkey with an objective assessment and the point of view of the parents, and to compare these two assessment methods.Materials and Methods: Twenty two cases (11 girls, 11 boys) with HIE who have undergone TH were included. Sixteen (72.7%) of the cases were classified as Sarnat Stage-2, and six (27.3%) of the cases were classified as Sarnat Stage-3. Motor development of the cases were evaluated by the Bayley Scales of Infant and Toddler Development-Third Edition (Bayley-III). Parents’views on their children’s development were examined with The Ages and Stages Questionnaire-2 (ASQ-2).Results: 68.2% (n=15) of the cases had normal motor development, 18.2% (n=4) had mild-moderate motor delay and 13.6% (n=3) had severe motor delay according to the Bayley-III motor scale results. When looking at the sub-areas of motor development, 68.2% (n=15) of the cases had normal gross motor development and 86.4% (n=19) of the cases had normal fine motor development. Additionally, 68.2% (n=15) of the cases demonstrated normal gross motor & fine motor development according to ASQ-2 results. Conclusion: Although there are some parallels in the results of the objective assessments and parental views regarding gross motor development, they differ in terms of fine motor development. However, ASQ-2 can be helpful for follow-up of children with HIE in situations where access to a clinician is limited or difficult and also it can provide an opinion to parents about their children’s development.

Keywords:

hypoxic ischemic encephalopathy, therapeutic hypothermia, motor development,

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