Tus American Academy of Pediatrics tau tso tawm thawj tsab cai hais txog "Kev Ntsuam Xyuas thiab Kev Ntsuam Xyuas ntawm Tus Menyuam Nrog ADHD" thiab "Kev Kho Mob ntawm Tsev Kawm Ntawv-Loj Hlob Nrog ADHD" hauv 2000 thiab 2001. Ua ke, lawv tau muab tswv yim rau cov kws kho mob pom zoo rau kev tshuaj ntsuam thiab kho lawv cov neeg mob nrog ADHD .
Thaum kawg lawv tau raug hloov hauv xyoo 2011 nrog rau tsab cai lij choj, "ADHD: Cov Ntawv Qhia Kev Kuaj Mob rau Kev Ntsuam Xyuas, Kev Soj Ntsuam, thiab Kev Kho Mob Teeb Meem / Mob Siab Tsis Taus Rau Cov Menyuam Yaus thiab Cov Hluas".
Cov txheej txheem ADHD tam sim no muaj cov tswv yim rau kev ntsuam xyuas thiab kev kho cov menyuam yaus ntawm 4 xyoos thiab 18 xyoos, qhov ntau dua li cov ntsiab lus qub uas tsis muaj cov menyuam yaus lossis cov hluas.
Diagnosing Kids nrog ADHD
Cov niam txiv feem ntau yog xav tsis thoob tias kev kuaj mob rau cov me nyuam nrog ADHD yog ib qho kev xav tsawg dua li lawv xav. Tom qab tag nrho, tsis muaj txoj kev kuaj ntshav lossis xoo hluav taws xob uas koj ua tau uas hais tau tias koj tus menyuam muaj ADD los yog ADHD .
Xwb, cov kws kho mob siv cov lus nug los tshawb xyuas thiab xyuas kom meej tias tus me nyuam ua tau raws li cov cai ntawm "Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition."
Leej twg yuav tsum xyuas?
Txhua tus me nyuam uas muaj "nrog rau kev kawm lossis kev coj tus cwj pwm thiab cov kev mob ntawm kev tsis sib haum, kev mob siab, los yog tsis zoo."
Ntxiv rau cov rooj sib tham ntawm ADHD, mus kuaj ADHD, lawv cov tsos mob yuav tsum ua rau muaj kev puas tsuaj thiab tsis txhob tshwm sim los ntawm lwm yam mob, xws li kev ntxhov siab , pw apnea, los yog kev kawm tsis meej, thiab lwm yam.
Cov txheej txheem kho ADHD kawg
Ntawm cov lus xaus thiab cov lus pom zoo hauv tsab cai no yog qhov kev paub tsis meej mob siab yuav tsum raug lees paub tias yog ib qhov kev mob ntev thiab qhov kev zov me nyuam tshwj xeeb, yuav tsum tsim kho rau cov menyuam yaus uas muaj lub hom phiaj los ua kom muaj kev zoo siab los txhim kho kev sib raug zoo thiab kev kawm hauv tsev kawm ntawv, txo kev coj cwj pwm, txhawb kev ruaj ntseg, nce kev ywj pheej thiab txhim kho tus kheej.
Lwm cov kev pom zoo muaj xws li cov tshuaj noj thiab / lossis kev coj tus cwj pwm yog cov kev kho kom haum thiab kev nyab xeeb rau ADHD thiab cov menyuam yaus yuav tsum tau soj qab taug lw thiab soj ntsuam los mus soj ntsuam cov hom phiaj thiab muaj kev mob tshwm sim. Ib qho ntawm qhov muaj zog, thiab kuv xav tias cov tswv yim feem ntau, cov lus pom hauv tsab cai qhia yog ua li cas rau cov menyuam uas tsis tuaj yeem tuaj teb rau cov kev kho mob. Ntau zaus, yog hais tias tus menyuam tsis tuaj yeem kho tshuaj los yog tseem muaj teeb meem, txoj kev kho mob raug tso tseg thiab nws tseem tshuav kom ua tsis tau zoo tom tsev kawm ntawv, muaj teeb meem kev coj cwj pwm thiab tsis zoo nrog lwm tus. Xwb, AAP pom zoo tias 'thaum tswj kev xaiv rau ib tus menyuam nrog ADHD tsis tau ntsib cov txiaj ntsim tau los, cov kws kho mob yuav tsum soj ntsuam cov kev kuaj mob, kev siv txhua yam kev kho mob, kev ua raws li kev npaj kho, thiab muaj cov xwm txheej mob.
Rau cov me nyuam uas muaj ADHD uas muaj teeb meem nrog cov cwj pwm tseem ceeb, nrog rau kev tsis txaus siab, mob siab, thiab kev xav tsis zoo, yog tias cov tshuaj tsis yog ib feem ntawm txoj kev kho mob thawj zaug, ces yuav tsum tau muab cov tshuaj kho kom zoo thiab yuav tsum tau kho tus cwj pwm. Cov menyuam yaus uas twb tau siv tshuaj kho mob hnyav thiab ua tsis zoo los yog muaj teebmeem tshwm sim , lawv yuav hloov mus rau lwm hom tshuaj kho.
Ntau cov nqe lus thiab cov lus xaus ntawm tsab cai no yuav tsum txhawb siab rau cov niam txiv, xws li:
- Kev ntsuam xyuas thiab kev soj ntsuam ntawm ntau cov kev tshawb fawb pom tau tias cov tshuaj kho hom kab mob ua hauj lwm rau cov tseem ceeb ntawm ADHD thiab ntau zaus 'pab txhawb tus me nyuam txoj kev muaj peev xwm ua raws li cov kev cai thiab txo cov kev xav tsis zoo, ua rau kev sib raug zoo nrog cov phooj ywg thiab niam txiv.
- Cov kev mob tshwm sim ntawm kev noj tshuaj yog feem ntau yog "me thiab luv luv," thiab rau cov niam txiv uas txhawj txog cov teebmeem ntawm cov tshuaj tua kabmob rau lawv tus menyuam txoj kev loj hlob, uas tsis muaj qhov tsis zoo ntawm qhov siab ua tau nyob rau hauv lub neej laus.
ADHD tshuaj
Tsab cai AAP tsab cai kuj muaj xws li tshuaj xyuas cov tshuaj uas siv los kho cov kev mob tshwm sim rau kev kho mob, xws li stimulants thiab non-stimulants.
Cov kab mob muaj xws li txawv ntawm cov methylphenidate:
- Short-acting, xws li Ritalin thiab Focalin, nrog rau 3-5 teev
- Intermediate-acting, xws li Ritalin SR, Metadate ER, thiab Methylin ER, nrog rau cov sijhawm 3-8 teev
- Ntev-ua yeeb yam, xws li Concerta, Daytrana, Metadate CD, Focalin XR, nrog 8-12 xuab moos thiab uas siv tau ib zaug ib hnub
Lwm hom kev ua kom muaj xws li txawv formulations ntawm amphetamine:
- Short-acting, xws li Dexedrine thiab Dextrostat, nrog ib ntu 4-6 teev ua ke, xws li Adderall thiab Dexedrine Spansule, nrog rau 6-8 teev
- Ntev-ua yeeb yam, xws li Adderall XR thiab Vyvanse
Muaj ntau cov uas tsis yog-stimulants kuj tam sim no muaj, nrog rau Strattera, Intuniv , thiab Kapvay. Feem ntau, AAP cov lus qhia tau hais tias cov pov thawj "zoo tshaj plaws rau cov tshuaj noj kom zoo thiab txaus tab sis tsis muaj zog." Uas feem ntau ua rau ntau tus kws kho mob thiab cov niam txiv los sim ua kom muaj kev kho mob ua kab thawj zaug.
Xaiv ib qho tshuaj ADHD
Nrog rau txhua yam sib txawv ntawm cov tshuaj ADHD , thiab ntau yam tshiab, koj yuav txiav txim siab seb leej twg thiaj siv tau rau koj tus menyuam? Qhov twg zoo tshaj plaws? Feem ntau, tsis muaj ib tug "zoo tshaj plaws" tshuaj thiab AAP hais tias 'txhua qhov kev mob plawv mob txhim kho cov tsos mob tseem ceeb.'
Lwm lo lus nug yog kev siv tshuaj npaum li cas. Tsis zoo li ntau lwm cov tshuaj, cov tshuaj stimulants tsis yog 'hnyav hnyav,' yog li 6 xyoo thiab 12 xyoos tej zaum yuav tsum yog tib lub sijhawm, los yog tus me nyuam yau yuav xav tau ntau dua. Vim tias tsis muaj cov kab ntau npaum li cas raws li tus menyuam qhov hnyav, cov tshuaj stimulants feem ntau yog pib siv tsawg thiab maj mam nce mus nrhiav tus me nyuam zoo tshaj plaws, uas 'yog ib qho uas ua rau pom kev zoo nrog cov kev phiv me me.' Cov kev mob tshwm sim no muaj xws li tsis qab los noj mov, mob taub hau, mob plab, muaj teeb meem mus pw, raug kev quab yuam, thiab kev tshem tawm, thiab feem ntau yog tswj tau los ntawm kev kho cov tshuaj noj los yog thaum noj tshuaj. Lwm cov kev mob tshwm sim nyob rau hauv cov menyuam yaus dhau ntawm cov khoom noj los yog cov uas muaj kev xav tau ntau tshaj rau cov stimulants thiab tej zaum yuav ua rau lawv 'overfocused rau cov tshuaj los yog tshwm sim los yog txwv tsis pub tshaj tawm.' Qee cov niam txiv tsis kam siv lub tshuab ua rau lawv vim tias lawv tsis xav kom lawv tus menyuam ua "zombie", tiam sis nws yog qhov tseem ceeb kom nco ntsoov tias cov kev mob no tsis zoo thiab feem ntau yuav raug kho los ntawm kev txo cov tshuaj noj lossis hloov mus rau sib txawv tshuaj.
Thiab vim hais tias 'tsawg kawg yog 80% ntawm cov menyuam yaus yuav teb rau ib qho stimulants,' yog 1 lossis 2 cov tshuaj tsis ua haujlwm lossis tsis muaj kev phom sij, ces qhov kev txiav txim siab zaum peb. Yog tias tus me nyuam pheej tsis teb rau kev kho mob, ces kev rov ntsuam xyuas dua yuav tsim nyog kom paub tseeb tias tus kab mob ADHD yog tus mob los yog nrhiav tej yam kev mob, xws li tsis sib haum xeeb, ua tsis zoo, ntxhov siab, kev nyuaj siab, thiab kev kawm tsis tau.
Lwm cov tshuaj ADHD
Ntxiv rau cov kev mob nkeeg, txoj cai lij choj pom zoo siv cov kev coj tus cwj pwm , uas yuav muaj kev cob qhia niam txiv thiab '8-12 cov pawg neeg txhua lub lim tiam nrog tus kws kho mob uas tau txais kev pauv' hloov tus cwj pwm hauv tsev thiab hauv chav kawm rau cov me nyuam nrog ADHD. Lwm cov kev pabcuam ntawm lub hlwb, nrog rau kev kho kev ua si, kev paub txog lossis kev paub txog tus cwjpwm, tsis tau raug pov thawj ua haujlwm thiab kev kho rau ADHD.
Lwm yam ntsiab lus tseeb txog ADHD uas tau hais hauv tsab cai no muaj xws li:
- 60-80% ntawm cov me nyuam uas muaj ADHD tseem muaj cov tsos mob hauv cov hluas
- 4-12% ntawm cov menyuam hnub nyoog kawm ntawv raug xav tias muaj ADHD
- Feem ntau siv cov stimulants tsis tau 'serologic, hematologic lossis electrocardiogram monitoring.' Txawm hais tias kev soj ntsuam txog kev ua haujlwm hauv lub siab yuav tsum tau txhaj rau cov menyuam yaus uas siv cov Cylert (uas tsis nquag siv ntxiv lawm), kev siv lwm tus stimulants tsis tas yuav tsum muaj cov kev kuaj ntshav niaj zaus.
- Cov ncauj lus muaj peev xwm ua rau tsis muaj kev cuam tshuam ntawm kev tsav tsheb, uas cov me nyuam tau siv 15-30% ntawm cov tshuaj stimulants, tab sis qhov muaj ntawm tics ua ntej lossis thaum tswj kev kho mob ntawm ADHD tsis yog ib qho kev tiv thaiv txog kev siv tshuaj kho mob.
Tus AAP "Kuaj Cov Lus Qhia Txog Kev Soj Ntsuam, Kev Ntsuam Xyuas, thiab Kev Kho Mob Teeb Meem / Mob Siab Tsis Taus Rau Cov Menyuam Yaus thiab Cov Hluas" yog cov tswvcuab zoo rau cov kws khomob uas saib xyuas cov menyuam nrog rau qhov teebmeem no thiab feem ntau tsis sib haum xeeb. Nws tuaj yeem pab tsim kev cob qhia niam txiv txog kev kho cov kev pabcuam, thiab thaum lawv yuav tsum nrhiav kev pab ntxiv.
> Qhov chaw:
> ADHD: Kuaj Cov Lus Qhia Txhaum Cai rau Kev Ntsuam Xyuas, Kev Ntsuam Xyuas, thiab Kev Kho Mob Teeb Meem / Mob Siab Tsis Taus Rau Cov Menyuam Yaus thiab Cov Hluas. Pediatrics Nov 2011, 128 (5) 1007-1022.