先天性心脏病对儿童心理行为的影响

Mentality and behavior of children with congenital heart diseases

目的研究先天性心脏病对儿童心理行为的影响，并对照研究介入治疗与外科手术对先天性心脏病患儿术后心理行为的影响。方法采用徐韬园1992年修订的Achenbach儿童行为量表对232例先天性心脏病患儿进行心理行为检测。结果先天性心脏病儿童心理行为异常检出率显著高于对照组。先天性心脏病各组患儿心理行为总粗分显著高于对照组（P〈0．01），先天性心脏病患儿心理行为粗分均值亦高于对照组（P〈0．01或P〈0．05）。男孩主要表现在抑郁、交往不良、体诉（各种躯体不适的反应）、社会退缩、违纪及攻击方面，女孩主要表现在抑郁、社会退缩、体诉、违纪方面。术后测试，男、女两治疗组心理行为总粗分分别显著低于治疗前（P〈0．01）。介入组男孩术后总粗分及攻击行为粗分分别低于外科组，差异具有统计学意义（P〈0．05），介入组女孩术后心理行为总粗分及抑郁、社会退缩和违纪行为粗分分别低于外科组，差异具有统计学意义（P〈0．05）。心理行为因子异常检出率与病程呈正相关，病程越长检出率越高。结论先天性心脏病患儿存在着明显的心理行为问题，应引起重视。早期治疗以及采用介入治疗方式可较明显改善先天性心脏病患儿的心理行为状况。

Objective The present study was designed to investigate the influence of Congenital Heart Disease （CHD） on the mentality and behavior in children, and to compare post operative mentality and behavior in children receiving interventional therapy and congenital heart surgery. Method Mentality and behavior of 232 children suffering from CHD were examined with Achenbach Child Behavior Checklist （CBCL） edited by XU Tao-yuan in 1992 and 100 sex, age, education and achievement-matched children with pneumonia were enrolled as controls. Results The mentality and behavior abnormal rates of the boys and girls suffering from CHD were significantly higher than those of controls （ P 〈 0. 01, P 〈 0. 05 ）. The behavior abnormities of the boys presented as depression, social flinch, physical complains, assault and violate rides. Whereas the girls presented as depression, social flinch, physical complains and violate rides. The total cursory mark of postoperative check result of the interventional and surgical children, both in girls and in boys, were significantly lower than those of the preoperative children （ P 〈 0. 05 ）. The total and assault cursory mark of postoperative check result of children treated with interventional therapy were significantly lower than those of children treated with the surgical operations （ P 〈 0. 05 ）. The abnormal rates of mentality and behavior positively correlated with the disease course. Conclusions CHD is associated with increased abnormal mentality and behavior of the children. Early treatment, especially the interventional therapy can significantly improve the mentality and behavior of the children with CHD.