先天性室间隔缺损对患儿心理行为的影响

目的了解先天性室间隔缺损(VSD)患儿的心理行为问题,并探讨外科手术与介入治疗对VSD患儿术后心理行为的影响。 方法将2006年1月至2007年5月住院治疗的132例VSD患儿分为介入组(n=68)和外科组(n=64)。采用徐韬园1992年修订的Achenbach儿童行为量表分别在术前和术后6个月对患儿进行心理行为检测。选取60名与CHD患儿一般特征相匹配的健康儿童为对照组。 结果VSD儿童心理行为异常检出率、心理行为总粗分、心理行为粗分均值均高于对照组(P<0.01或P<0.05)。男孩主要表现在抑郁、交往不良、体诉、社会退缩、违纪及攻击方面;女孩主要表现在抑郁、社会退缩、体诉、违纪方面。心理行为因子异常检出率与病程呈正相关,病程越长检出率越高。术后测试,男、女两组心理行为总粗分均显著低于治疗前(P<0.01)。男孩介入组术后总粗分及攻击行为粗分分别低于外科组(P<0.05),女孩介入组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低于外科组(P均<0.05)。结论VSD患儿存在较明显的心理行为问题,采用早期治疗以及介入治疗可较明显改善VSD患儿的心理行为状况。

Mentality and behavior of children with congenital ventricular septal defect

Objective To investigate the mentality and behavior of children with congenital ventricular septal defect(VSD) and to explore the influence of interventional versus surgical procedure of VSD on mentality and behavior.Methods From January 2006 to May 2007,132 children suffering from VSD,without associated structural cardiac anormalies,were divided into two groups: the interventional group(n=68) and the surgical group(n=64).The Achenbach Child Behavior Checklist(CBCL) edited by Xu Tao-yuan in 1992 was performed on these children before and 6 months after treatment.Sixty sex,age,education and achievement-matched normal children were enrolled as controls.Results Mentality and behavior of children with VSD were abnormal.The total behavioral problem scores of the VSD children were significantly higher than those of the controls(P<0.01).Behavior abnormities of boys were depression,social flinch,physical complaints,assaults and violation of rules.Whereas girls presented depression,social flinch,physical complaints and violation of rules,which was significantly different from normal children(P<0.01 or P<0.05).The abnormal rates of mentality and behavior positively correlated with course of disease.The total cursory mark of the post-operative check result of the interventional and surgical groups,both in girls and boys,was evidently lower than those of the pre-operative children(P<0.05).The total and assault cursory mark of the post-operative check result of the interventional boys were lower than those of the surgical ones(P<0.05).The total and depression,social flinch,violation of rules cursory mark of the post-operative check result of the interventional girls were lower than those of the surgical ones(P<0.05).Conclusion VSD affects mentality and behavior of children,which should be paid more attention to,also early treatment andinterventional therapy can evidently improve mentality and behavior of children with VSD.