先天姓心脏病及其治疗方式对病儿心理行为的影响

目的 探讨外科修补术与介入治疗对先天性心脏病(CHD)病儿心理行为影响,并进一步评价不同年龄段病儿治疗前、后心理行为的差异.方法 采用中国标准化的Achenbach儿童行为量表对CHD病儿分别在术前和术后1年进行心理行为测试,探讨不同的治疗方式对病儿心理行为的影响,并分别对两治疗组中高、低年龄段病儿进行治疗前、后比较.选取健康儿童作为对照组.结果 治疗前各组CHD病儿心理行为异常检出率、心理行为总粗分均显著高于健康对照组(P＜0.01),男、女各组均表现有抑郁、体诉、社会退缩、违纪行为.治疗后1年测试,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),外科组男孩术后总粗分及攻击行为粗分分别高于介入组(P＜0.05),外科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高于介入组(P＜0.05).术前高年龄组病儿心理行为总粗分均分别高于低年龄组(P＜0.05),外科治疗后高年龄组心理行为总粗分高于低年龄组(P＜0.05).结论 先天性心脏病影响病儿心理行为的健康发展,早期治疗可明显改善病儿的心理行为状况.与介入治疗相比,外科修补术后较长时间内应给予病儿更多的心理帮助,以利身心健康早日恢复.

Mortality and behavior changes after surgery or interventional treatment for congenital heart disease in childbood

Objective To evaluate the mentality and behavior of children with congenital heart disease (CHD),and to compare surgical procedure versus interventional therapy for CHD in children of different ages and their influence on mentality and behavior.Methods From July 2005 to January 2008,160 children suffering from ventricular septal defect (VSD) or atrial septal defect (ASD),without other cardiac anomalies,were divided into two groups:surgical group(n=80) and interventional group(n=80).We performed Chinese standard Achenbach Child Behavior Checklist(CBCL) on these children before and 1 year after the treatment.Sixty normal children sex,age,education and achievement-matched were enrolled as control.Results The mentality and behavior of the children with CHD were obviously abnormal before treatment (P＜0.01).The abnormal rates of the boys and girls suffering from CHD were evidently higher than those of the healthy control subjects (P＜0.01).The behavior abnormities of CHD children presented depression,social flinch,somatic complaints and delinquency,which were significantly different from the healthy children.The total cursory mark of postoperative check results of the surgical and interventional groups,both in girls and in boys,significantly lower than those of the preoperative results(P＜0.05).The total and aggression cursory mark of postoperative check results of the surgical boys were higher than those of the interventional subjects(P＜0.05).The total depression,social flinch,aggression cursory mark of postoperative check results of the surgical girls were higher than those of the interventional ones (P＜0.05).The total cursory mark of elder children was significantly higher than those of the younger ones before treatments (P＜0.05).The postoperative total cursory mark of older children treated with surgical operations was higher than those of the younger controls in the same treatment group(P＜0.05).Conclusion CHD significantly affected the mentality and behavior of the children.Early treatments may alleviate the mental and behavior abnormality.Cardiac surgery dose not result in early postoperative improvements in mentality and behavior for children CHD in a certain period.