小儿心因性疾病临床探讨

Clinical exploration of psychogenic diseases in childhood

目的 探讨儿童心因性疾病发病诱因、临床表现、治疗及预后。方法 分析总结 6 6例儿童心因性疾病临床与辅助资料。结果 6 6例患儿大多为学龄儿童 ,且均有不良精神因素刺激 ,其中校园因素占 31例(47% ) ,家庭因素占 18例 (2 7% ) ,躯体疾病占 11例 (17% ) ,其他 6例 ,如惊吓、胆怯、意外事故等。临床表现各异 ,以瘫痪和抽搐最多 ,各占 36 %和 18%。治疗以心理治疗和暗示治疗为主 ,效果明显 ,预后良好。结论 儿童心因性疾病并不少见 ,其发病与社会及家庭环境关系密切 ,故家长和老师应加强对学龄儿童精神心理教育 ,以降低该病的发生。同时该病表现多样 ,易误诊 。

Objective Study of inducing factor,clinical manifestation,therapy and prognosis of child′s psychogenic diseases.Method A retrospective clinical study of 66 cases with child psychogenic diseases was carried out based on the data from the patients records.Result All patients ,most of them were of school age,had been subjected to unfavorablly psychogenic factors which include school factors(n=31,47%),family factors (n=18,27%),post somatopathic factors (n=11,17%), and other factors 6 cases such as fright ,shyness and accident.Although clinical manifestations of the disease differ from each other,paralysis(n=24,36%)and convulsion(n=12,18%)are of the most common symptoms.Psychotherapy and suggestion therapy are the two important treatments;in spite of recurrence of some cases,both curative effect and prognosis are good.Conclusion Child′s psychogenic disease is not of rare one,the disease is closely related to society and family.To reduce the incidence of the disease,parents and teachers should strengthen school aged children′s psychogenic education.Because of variety of clinical manifestation,the disease tends to be misdiagnosed,therefore pediatrician should pay much attention to it.