儿童阴道异物病例分析及相关心理健康研究

Analysis of young children′s vaginal foreign bodies and related study on their mental health

目的分析女童阴道异物的理想诊断方法,呼吁社会及家庭对学龄前女童相关心理健康的关注和重视。方法回顾分析2015年1月-2016年12月在西安交通大学第二附属医院小儿外科收治的4例经超声诊断为阴道异物,并手术确诊取出异物的4例患儿其临床表现及超声诊断特点。采用质性研究描述现象的方法,通过访谈方式对患儿及家长进行心理行为分析,进而探讨相关的心理健康影响因素。结果阴道异物表现为幼儿阴道出血、异常分泌物,经腹及会阴部超声检查表现为阴道内的异常强回声及脓性分泌物。心理行为分析结果显示4例患儿属于启动缓慢型气质。同时,患儿均处于学前教育期,是早期性教育的关键期。父母学历低,家长与学校对儿童性教育的不重视是发生该行为的重要原因。结论超声是诊断女童阴道异物的理想检查手段。家庭及学校对学龄前儿童性教育的缺乏影响幼儿心理健康,继而导致问题行为如阴道异物的发生。

Objective To discuss an ideal diagnostic method of young children′s vaginal foreign bodies, and to appeal for the high attention from society and family on preschool children′s mental health. Methods Retrospective analysis was conducted on four young children admitted in the Pediatric Surgery Department of the Second Affiliated Hospital of Xi′an Jiaotong University from January 2015 to December 2016. Four children′s vaginal foreign bodies were diagnosed by ultrasound and demonstrated after operation. Their clinical manifestation and ultrasonographic features were analyzed. A qualitative research method for describing the phenomenon was employed. Through interviews, children and their parents＇ psychological behaviors were analyzed and then the related influencing factors of mental health were determined. Results The leading symptoms of vaginal foreign bodies were children′s vaginal bleeding and abnormal secretion. By abdominal and perineal ultrasonic examination, endovaginal abnormal hyperecho and purulent secretion were observed. The Results of psychological behavior analysis revealed those four children belonged to the slowly-warm-up temperament. Meanwhile, they were in the preschool period in which it is vital for executing early sex education. Nevertheless, their parents were generally in low education level. Both of the children′s parents and schools did not pay attention on the sex education to young children, which was the significant cause of the occurrence of vaginal foreign bodies. Conclusions Ultrasonic examination is an ideal means to diagnose young children′s vaginal foreign bodies. Family and school lack sex education to young children, leading to impact on their mental health, thereby causing behavioral problem like vaginal foreign bodies.