[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"$f4D2XitJXFoBVh9qj3-PDJIGDyeA965zR_A5LnK2iD_c":3,"$f65-g5LTUgHIk8dGZIHhGe2pKpxnfW0g-O4HGxk3yxcs":11,"$fVcX0Ca2rRmmBou2PEc3IN9J8TAHZkasyRaFDmkiDDwo":15,"$fFDkDP12E2d4JPDGfVX4YCQ7CsZRVfG9TTN5P63sO7XY":21},{"code":4,"msg":5,"message":6,"data":7,"success":10},200,"操作成功",null,{"authors":8,"appraiseDimensionScoresVos":9},[],[],true,{"code":12,"msg":13,"message":6,"data":6,"success":14},401,"认证失败，无法访问系统资源",false,{"code":4,"msg":5,"message":6,"data":16,"success":10},{"pageNo":17,"pageSize":18,"result":19,"totalSize":20},1,10,[],0,{"code":4,"msg":5,"message":6,"data":22,"success":10},{"id":23,"specialistId":24,"specialistAssistants":25,"profilePhoto":26,"specialistName":27,"hospital":28,"department":29,"postsTitle":30,"materialTotal":31,"videoTotal":20,"isConcern":14,"title":32,"coverVertical":33,"coverAcross":34,"content":35,"description":36,"views":37,"likes":20,"isThumbsUp":14,"isCollection":14,"collections":20,"createTime":38,"seoTitle":32,"seoKeywords":39,"seoDescription":40,"shelvesTime":41,"version":42,"menus":43,"menuId":45,"type":17,"quality":62,"commentCount":20,"isComment":17},88074,971152,[],"https://ystcdn.venuertc.com/venue/app/47785/2026-06-25/265577bd-5abd-43d8-9d6c-6b46438ad818.png","张利亚","苏州大学附属儿童医院","儿科","主任医师",40,"抽动障碍：儿童健康管理的重要话题","","https://ystcdn.venuertc.com/venue/AI/eb730536-933b-4fcc-ab2a-8a244c102ae8.jpg","\u003Cdiv class=\"mdp-health-guide\">\n  \u003Ch1 id=\"material_title\" class=\"mdp-title\">抽动障碍：儿童健康管理的重要话题\u003C/h1>\n\n  \u003Cdiv class=\"mdp-section mdp-bg1\">\n    \u003Ch2 class=\"mdp-subtitle\">01 抽动障碍是什么？🤔\u003C/h2>\n    \u003Cdiv class=\"mdp-content\">\n      \u003Cp>\n        家长有时会发现，孩子会做出一些奇怪的小动作，比如频繁眨眼、耸肩，或者时不时地发出清嗓子的声音。通常大家会觉得是调皮、注意力不集中，甚至以为是习惯问题。不过，实际上这些表现可能源自一种叫做“抽动障碍”的神经系统疾病。简单来说，\u003Cspan class=\"mdp-highlight\">抽动障碍\u003C/span>就是孩子在没有意识的情况下反复做出同样的动作或声音。\u003Cbr>\n        \u003Cspan class=\"mdp-note\">抽动障碍被列为神经发育障碍之一，较多在学龄期儿童中出现（Robertson, M. M., 2015）。\u003C/span>\n      \u003C/p>\n      \u003Cp>\n        这种情况虽然不会直接影响孩子的大脑智能或者成长发育，但如果长期存在，会影响到自信心、人际关系，甚至学习表现。一些孩子可能因为这个问题而感到自卑或者受到同学的误解。从家长的角度，清楚认识和早做应对，能让孩子避免很多成长的烦恼和压力。\n      \u003C/p>\n    \u003C/div>\n  \u003C/div>\n\n  \u003Cdiv class=\"mdp-section mdp-bg2\">\n    \u003Ch2 class=\"mdp-subtitle\">02 抽动障碍的症状表现有哪些？👀\u003C/h2>\n    \u003Cdiv class=\"mdp-content\">\n      \u003Cp>\n        症状出现时，有点像是生活中的“小怪癖”，但其实可以细分为以下几种常见类型：\n      \u003C/p>\n      \u003Cul class=\"mdp-list\">\n        \u003Cli>\n          \u003Cspan class=\"mdp-point\">1. 运动型抽动：\u003C/span>比如不停地眨眼、扭头、耸肩、鼓腮、吸鼻子，看起来就像不由自主地做小动作。\n        \u003C/li>\n        \u003Cli>\n          \u003Cspan class=\"mdp-point\">2. 发声型抽动：\u003C/span>最常遇到的是清嗓子、咳咳声、鼻子哼声，有时候还会出现类似口头禅的短语或者怪声。\n        \u003C/li>\n      \u003C/ul>\n      \u003Cp>\n        绝大多数刚开始的时候，孩子偶尔才会有这些表现，很容易被误认为是“顽皮”或“习惯不好”。比如我们的病例：\u003Cspan class=\"mdp-highlight\">8岁男孩，最近总是不自主地清嗓子，晚上睡着后这动作就消失了，平时精神状态都很好。\u003C/span>\n      \u003C/p>\n      \u003Cp>\n        到了症状明显的阶段，动作或声音变得频繁甚至影响正常生活，比如上课时控制不住地眨眼或清嗓子，老师和同学也会觉得奇怪。如果孩子长时间持续类似表现，最好带去专科门诊进一步检查。\u003Cbr>\n        \u003Cspan class=\"mdp-note\">International Parkinson and Movement Disorder Society 的标准提到，症状至少持续超过一年且出现多种运动及一个以上发声抽动，才可以诊断为Tourette 综合征（Pringsheim, T., et al., 2019）。\u003C/span>\n      \u003C/p>\n    \u003C/div>\n  \u003C/div>\n\n  \u003Cdiv class=\"mdp-section mdp-bg3\">\n    \u003Ch2 class=\"mdp-subtitle\">03 为什么会得抽动障碍？🔬\u003C/h2>\n    \u003Cdiv class=\"mdp-content\">\n      \u003Cp>\n        说起来，抽动障碍背后的原因其实有点复杂，不是简单的“习惯问题”或管教方式导致。大致上，科学家们认为和下面这些因素相关：\n      \u003C/p>\n      \u003Cul class=\"mdp-list\">\n        \u003Cli>\n          \u003Cspan class=\"mdp-point\">遗传因素：\u003C/span>\n          家族里有类似情况的孩子更容易发作。权威研究提示，抽动障碍有一定的遗传倾向（Leckman, J. F., et al., 2014）。\n        \u003C/li>\n        \u003Cli>\n          \u003Cspan class=\"mdp-point\">神经递质失衡：\u003C/span>\n          脑内多巴胺等神经递质“调控”出现紊乱时，会让孩子出现不自主的动作和声音。\n        \u003C/li>\n        \u003Cli>\n          \u003Cspan class=\"mdp-point\">环境和压力：\u003C/span>\n          紧张、焦虑、缺乏睡眠、突然环境变化，比如搬家、换老师，都可能促发或加重症状。\n        \u003C/li>\n        \u003Cli>\n          \u003Cspan class=\"mdp-point\">合并症影响：\u003C/span>\n          有些孩子还会合并变应性鼻炎、注意缺陷多动障碍等，可能使抽动症状表现更复杂。\n        \u003C/li>\n      \u003C/ul>\n      \u003Cp>\n        其实，简单来说，每个孩子的具体原因可能不一样。\u003Cspan class=\"mdp-highlight\">这提醒我们，不必过分归咎于某个细节，关键是及早识别和科学管理。\u003C/span>\n      \u003C/p>\n    \u003C/div>\n  \u003C/div>\n\n  \u003Cdiv class=\"mdp-section mdp-bg4\">\n    \u003Ch2 class=\"mdp-subtitle\">04 抽动障碍如何正确诊断？📋\u003C/h2>\n    \u003Cdiv class=\"mdp-content\">\n      \u003Cp>\n        某些抽动现象不都是抽动障碍，判断是否为疾病，还需要专业医生。\n      \u003C/p>\n      \u003Cul class=\"mdp-list\">\n        \u003Cli>\n          \u003Cspan class=\"mdp-point\">病史咨询：\u003C/span>医生会详细询问孩子首次出现异常动作/声音的时间、表现、持续时长，以及是否有家族成员有类似问题。\n        \u003C/li>\n        \u003Cli>\n          \u003Cspan class=\"mdp-point\">体格检查：\u003C/span>通过观察动作类型、是否受自己控制、有没有跟环境变化有关。\n        \u003C/li>\n        \u003Cli>\n          \u003Cspan class=\"mdp-point\">诊断标准：\u003C/span>常用DSM-5标准，需要运动和/或声音抽动持续1年以上，发作前后的诱因和缓解因素也会逐步分析。\n        \u003C/li>\n        \u003Cli>\n          \u003Cspan class=\"mdp-point\">排除其他疾病：\u003C/span>有些类似症状，比如频繁清嗓子，也可能是鼻炎或咽喉发炎导致，医生通常会结合检查排除器质性病变。\n        \u003C/li>\n      \u003C/ul>\n      \u003Cp>\n        \u003Cspan class=\"mdp-highlight\">如果症状长期未缓解，或者越来越重，应及时前往神经内科门诊进行随访复查。\u003C/span>有些家长担心做脑电图、头颅影像等，其实大多数典型病例无需复杂仪器，仅靠详细问诊和体检即可确诊。\u003Cbr>\n        \u003Cspan class=\"mdp-note\">DSM-5 diagnostic criteria: American Psychiatric Association, 2013\u003C/span>\n      \u003C/p>\n    \u003C/div>\n  \u003C/div>\n\n  \u003Cdiv class=\"mdp-section mdp-bg5\">\n    \u003Ch2 class=\"mdp-subtitle\">05 抽动障碍的治疗方法有哪些？💊\u003C/h2>\n    \u003Cdiv class=\"mdp-content\">\n      \u003Cp>\n        目前抽动障碍的治疗主要分为两大类：药物和行为干预。99%的家长都想知道哪种最适合自己的孩子，下面我们分开来说：\n      \u003C/p>\n      \u003Cul class=\"mdp-list\">\n        \u003Cli>\n          \u003Cspan class=\"mdp-point\">药物治疗：\u003C/span>如果症状很严重，或影响学习生活，医生会考虑用药。常用的是改善神经递质平衡的药物，比如阿立哌唑、利培酮等。不过，这类药必须严格在医生指导下使用，定期复诊，防止副作用（Steeves, T. D. L., et al., 2012）。\n        \u003C/li>\n        \u003Cli>\n          \u003Cspan class=\"mdp-point\">行为干预：\u003C/span>《习惯反转训练（HRT）》等心理方法，能帮助孩子自我识别抽动的前兆，然后学会用其他“安全动作”去替换、缓解原有的抽动。很多家长反馈，这类训练如果坚持做，常有不错的改善效果。\n        \u003C/li>\n        \u003Cli>\n          \u003Cspan class=\"mdp-point\">合并症管理：\u003C/span>像变应性鼻炎、注意缺陷等共患疾病一并稳定下来，有助于控制整体症状。\n        \u003C/li>\n      \u003C/ul>\n      \u003Cp>\n        \u003Cspan class=\"mdp-highlight\">需要明确一点，治疗选择前一定要由专科医生综合判断，很多孩子随年龄增长，抽动症状本身就会自然减轻，不建议自行频繁换药或停药。\u003C/span>\n      \u003C/p>\n    \u003C/div>\n  \u003C/div>\n\n  \u003Cdiv class=\"mdp-section mdp-bg6\">\n    \u003Ch2 class=\"mdp-subtitle\">06 家庭照护：怎样帮孩子走得更轻松？🏡\u003C/h2>\n    \u003Cdiv class=\"mdp-content\">\n      \u003Cp>\n        家里的关爱，比什么药都重要。综合专家建议和家庭经验，有几条关键建议，能切实帮助孩子缓解症状、建立自信：\n      \u003C/p>\n      \u003Cul class=\"mdp-list\">\n        \u003Cli>\n          \u003Cspan class=\"mdp-point\">保证充足睡眠：\u003C/span>早点睡，保证每天8小时左右的高质量休息，特别能帮助缓解抽动。缺觉时孩子往往症状会更重。\n        \u003C/li>\n        \u003Cli>\n          \u003Cspan class=\"mdp-point\">饮食均衡：\u003C/span>多摄入富含B族维生素、铁、锌的食物。例如菠菜、瘦肉、蛋类可帮助神经发育和能量代谢；水果和新鲜蔬菜富含抗氧化剂，对孩子健康有帮助（Raiford, K. L., & Modlin, D. L., 2019）。\n        \u003C/li>\n        \u003Cli>\n          \u003Cspan class=\"mdp-point\">合理释放压力：\u003C/span>引导孩子参加运动，户外活动，转移对抽动表现的注意力。例如慢跑、打球、游泳，既能让身体舒展，也让心理更放松。\n        \u003C/li>\n        \u003Cli>\n          \u003Cspan class=\"mdp-point\">创造支持环境：\u003C/span>不盯着、不频繁提醒抽动动作，家里的气氛轻松宽容。一旦发现同伴歧视或不理解，及时跟老师、同学沟通。\n        \u003C/li>\n        \u003Cli>\n          \u003Cspan class=\"mdp-point\">定期专业随访：\u003C/span>配合定期去神经内科门诊复查，根据医生建议动态调整干预方案。出现新的症状变化一定要尽早就医，避免自行处理。\n        \u003C/li>\n      \u003C/ul>\n      \u003Cp>\n        这些措施虽然看上去普通，但只要坚持下来，会给孩子和家庭带来长期的益处。研究也证实，宽松有爱的环境和规律生活，对控制疾病进展有很大帮助（Zinner, S. H., et al., 2012）。\n      \u003C/p>\n    \u003C/div>\n  \u003C/div>\n\n  \u003Cdiv class=\"mdp-section mdp-bg7\">\n    \u003Ch2 class=\"mdp-subtitle\">07 总结与行动建议📝\u003C/h2>\n    \u003Cdiv class=\"mdp-content\">\n      \u003Cp>\n        生活中遇到类似孩子反复抽动的问题，多数家人会有担忧甚至焦虑，不过真正有效的是理性看待和科学支持。抽动障碍虽然烦人，但绝大部分孩子可以通过管理得到很好控制。再好的医生也代替不了家庭的理解和呵护，科学随访、积极配合，让孩子像正常孩子一样健康成长，是每个家庭可以做得到的。如果你遇到类似情况，不妨回头看看上面的建议和步骤，让孩子多一分信心，也让家庭多一分淡定。\n      \u003C/p>\n    \u003C/div>\n  \u003C/div>\n\n  \u003Cdiv class=\"mdp-refs\">\n    \u003Ch3 class=\"mdp-ref-title\">参考文献\u003C/h3>\n    \u003Col>\n      \u003Cli>Robertson, M. M. (2015). A personal 35-year perspective on Gilles de la Tourette syndrome: Assessment, investigations, and management. \u003Ci>The Lancet Psychiatry\u003C/i>, 2(1), 88-104.\u003C/li>\n      \u003Cli>Leckman, J. F., Bloch, M. H., Scahill, L., & King, R. A. (2014). Tourette syndrome: the self under siege. \u003Ci>Journal of Child Neurology\u003C/i>, 29(12), 1612-1625.\u003C/li>\n      \u003Cli>Pringsheim, T., Okun, M. S., Müller-Vahl, K., Martino, D., Jankovic, J., Cavanna, A. E., ... & Eddy, C. M. (2019). Practice guideline recommendations summary: Treatment of tics in people with Tourette syndrome and chronic tic disorders. \u003Ci>Neurology\u003C/i>, 92(19), 896-906.\u003C/li>\n      \u003Cli>Steeves, T. D. L., McKinlay, B. D., Gorman, D., Day, L., Heath, E., & Robertson, M. M. (2012). Canadian guidelines for the evidence-based treatment of tic disorders: pharmacotherapy. \u003Ci>Canadian Journal of Psychiatry\u003C/i>, 57(3), 133-143.\u003C/li>\n      \u003Cli>American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.\u003C/li>\n      \u003Cli>Raiford, K. L., & Modlin, D. L. (2019). The Role of Nutrition and Dietary Supplements in the Management of Tourette Syndrome. \u003Ci>Child and Adolescent Psychiatric Clinics\u003C/i>, 28(3), 377-390.\u003C/li>\n      \u003Cli>Zinner, S. H., Conelea, C., Glew, G. M., Woods, D. W., Budman, C., & Peterson, A. (2012). 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