儿童转换型癔症66例临床分析

Clinical analysis of childhood conversion hysteria in 66 cases.

目的总结儿童转换型癔症临床特征及发病诱因,以便早期诊治和预防。方法回顾总结2008年1月至2013年1月中国医科大学附属第一医院儿科收治的66例儿童转换型癔症资料,进行临床分析。结果 66例转换型癔症临床症状复杂多样,以癔症性运动障碍(30.6%)、癔症性感觉障碍(28.8%)、癔症性抽搐发作(21.7%)为主;发作常由于精神因素引起,学习困难、学校恐怖症、担心考试是最常见的诱发因素。采用暗示治疗、心理治疗和抗焦虑镇静药联合治疗多有效。结论儿童转换型癔症很常见,因缺乏显著特征易误诊,所以在临床工作中应提高警惕;还须注意与其他精神障碍进行鉴别。

Objective To analyse the clinical characters and the precipitating factors in 66 cases with conversion hysteria, in order to raise awareness of this disease and improve the early diagnosis and treatment as well as the prevention. Methods Various preonset data and clinical manifestations of 66 children with conversion hysteria were retrospectively analyzed. Results The clinical symptoms of 66 children with conversion hysteria were complicated for diverse clinical manifestations.The clinical demonstrations included hystericalmotordisorders（30.6%）,hystericalsensorydisorders（28.8%） and hystericalconvesions （21.7%）.All onsets are accompanied by psychological irritability, School phobia and the fear of examinations were the most common precipitating factors.The suggestion therapy combined with psychotherapy and anti- anxietic drugs was effective. Conclusion Although childhood conversion hysteria is common, it is easy to be misdiagnosed for various symptoms without specificity.Thus we should summarize the experience and improve awareness, and also pay attention to make differentiate with the other psychonosema.