先天性心脏病患儿心理学特点的对照研究

目的研究先天性心脏病对儿童心理行为的影响。 方法采用艾森克个性问卷(儿童) 手册（EPQ）、Achenbach 儿童行为评定量表（CBCL）、联合型瑞文测验（CRT）、适应能力商数（SAB）量表对113例先天性心脏病（CHD）患儿进行个性、行为、智力及适应能力的心理检测。选取100名与CHD患儿一般特征相匹配的上呼吸道感染儿童为对照组。 结果与对照组相比，CHD儿童N质个性明显高于对照组（P<0.001）。CHD儿童心理行为异常检出率显著高于对照组（P<0.01）。CHD患儿心理行为总粗分显著高于对照组（P<0.01），心理行为粗分均值亦高于对照组（P<0.01或P<0.05）。男孩表现在抑郁、交往不良、体诉、社会退缩、违纪及攻击方面，女孩表现在抑郁、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。患儿平均智商与对照组比较，差异无显著意义（P>0.05），但D单元得分低于对照组（P<0.05）。适应能力商数低于对照组，主要表现为独立功能因子、社会/自制因子得分低于对照组（P<0.001或P<0.05）。结论CHD患儿表现出情绪不稳的个性特点，存在着明显的行为问题。虽然患儿智商正常，但独立功能因子和社会/自制因子方面显著低于对照组儿童。

A controlled study on psychological characteristics of children suffering from congenital heart disease

Objective To investigate the psychological characteristics of children with congenital heart disease(CHD).Methods The personality,behavior,intelligence quotients(IQ) and social adaptive behavior(SAB) of 113 children suffering from CHD were determined by means of EPQ,CBCL,CRT and SAB scales.One hundred sex-,age-,education-and achievement-matched children with upper respiratory infection were enrolled as controls.Results The N score of the CHD group was obviously higher than that of the control group(P<0.001).More CHD children had abnormal mentality and behavior than the controls(P<0.01).The CHD children had depression,social flinch,physical complaints,assault and violated rules, which were significantly different from the controls.The abnormal rates of mentality and behavior positively correlated with the course of the disease.The mean IQ was not significantly different between the two groups(P>0.05),however,the score of D unit in the CHD group was lower than that in the control group(P<0.05),and the adaptive deviation quotient(ADQ) was also significantly lower in the CHD group than that in the control group,especially the self-care factor and social/self-direction factor(P<0.001 or P<0.05).Conclusion Children suffering from CHD have neurotic characteristics and obvious behavior problems,but their IQ is normal,and their social adaptive behavior,particularly the self-care factor and social/self-direction factor are worse than those of the controls.