颅咽管瘤心理学人格特征变化的分析性研究

Analytic study on changes of psychological personality characteristics in craniopharyngioma

目的探究颅咽管瘤患者术前与术后的人格特征,探讨肿瘤的侵袭程度及手术对颅咽管瘤患者人格特征的影响。方法在术前及术后对各组患者分别进行明尼苏达多项人格测试(MMPI)的问卷调查,共收集资料19例,将术前、术后及中国常模的各量表评分进行比较。结果术前患者各分量表在Hs、D、Hy、Pd、Pt、Sc指标上与常模比较,颅咽管瘤患者的得分均值大于常模,差异有统计学意义(P<0.05)。术后患者在D、Si指标上与术前比较差异有统计学意义(P<0.05)。肿瘤分级与MMPI各分量表之间的关系显示,type 2级患者在术前的Hy、Pd、Ma指标上较其他分级显著增高。颅咽管瘤患者type 2级与type 0、type 1级比较,术前、术后人格特征的改变差异有统计学意义(P<0.05)。结论肿瘤对下丘脑的侵犯程度是患者认知与人格特征改变的重要影响因素,手术对下丘脑及邻近边缘系统的保护和术前术后的心理学辅导至关重要。

Objective To explore the preoperative and postoperative personality characteristics in the patients with craniopharyngioma and to investigate the tumor invasive degree and the effect of surgery on the personality characteristics in the patients with craniopharyngioma.Methods The questionnaire investigation was preoperatively and postoperatively performed by using the Minnesota multiple personality test questionnaire（MMPI）in the patients of various groups.The data in 19 cases were collected data.The scores of various scales were compared among preoperation,postoperation and Chinese norm.Results The scores of Hs,D,Hy,Pd,Pt and Sc indexes in various subscales before operation in the craniopharyngioma patients were significantly greater than those in the norm,the differences were statistically significant（P〈0.05）.The D and Si indexes had statistical difference between before and after operation（P〈0.05）.The relationship between the tumor classification and MMPI subscales showed that the scores of preoperative Hy,Pd and Ma indexes in the patients with type 2craniopharyngioma were significantly increased compared with other grades.The preoperative and postoperative personality characteristics change had statistical difference between the type 2with the type 0and type 1（P〈0.05）.Conclusion The invasion degree of tumor to hypothalamus is an important influencing factor of cognition and personality characteristics change.It is of great importance to protect the hypothalamus and adjacent limbic system and preoperative and conduct postoperative psychological coaching.