儿童急性白血病长期持续化疗后智力与心理行为的调查分析

Investigation and analysis of the intelligence and mentality in children with acute leukemia after long-term chemotherapy

目的了解儿童急性白血病长期持续化疗对智力与心理行为的影响。方法27例急性白血病患儿，经长期化疗，已获得3年以上生存。27例均进行智商测定选用儿童联合型瑞文测试（CRT）；心理行为测定：13例12岁以上患儿采用90项自觉症状自评量表（SCL-90），14例12岁以下患儿采用心理健康诊断测试（MHT）。所得结果与我国常模相比较。结果27例患儿平均智商为107，与正常儿童相比较，无显著的统计学差异（P〉0．05）；13例患儿SCL-90量表总均分为1．58，各因子分均值在1．39—1．79之间，其中人际关系、强迫症状，敌对、偏执得分最高；14例心理健康诊断测试（MHT）无一例患儿全量表标准分≥65，说明白血病患儿总体焦虑程度不高。学习焦虑迭（85．71％），说明学习焦虑程度较高。其次是自责倾向（21．43％）、过敏倾向（21．43％）、孤独倾向（7．14％）、身体症状（7．14％）。结论儿童急性白血病长期持续化疗对智力无明显影响，但存在一定程度的心理行为的影响，尤其在人际关系、学习焦虑方面，提示我们需要加强白血病患儿的心理支持。

Objective To understand the apy in children with acute leukemia. Methods intelligent and mental effect caused by long-term chemother- 27 children with acute leukemia in continuous complete： remission for more than 3 years after long-term chemotherapy were investigated. Intelligence quotient （IQ） was measured by means of Combined Raven Test （CRT）. Mentality was measured by means of Symptom Checklist 90 （SCL-90） and Mental Heahh Test （MHT）. All the children were tested by CRT, 13 children more than 12-years old by SCL-90, 14 children lower than 12-years-old by MHT. The scores were compared with the normal standard establised in China. Results The mean IQ of the 27 children with acute leukemia was 107 and there was no significant difference compared with the normal standard （ P 〉 0. 05 ）. The total average score of SCL-90 was 1.58, average score of individual factor was 1.39 - 1. 79. The main serious symptom factors were interpersonal sensitivity, compelling symptom, crankiness and hostility. The total score of MHT of all the 14 children were lower than 65, revealed that the total tendency of anxiety was not high. But 85.71% of children had learning anxiety, 21.43 % had tendency of being oversensitive and self respectively, 7. 14% had tendency of isolation and body symptom. Conclusions There is no significant intelligent and mental effect by long-term chemotherapy in children with acute leukemia. But there are some mental problems among children with acute leukemia after long-term chemotherapy. So we should pay attention to mental support and psychological therapy.