单侧唇裂修复对患儿及其父母心理状况影响的研究

发布时间：2018-05-18 08:32

  本文选题：唇裂 + 手术修复　； 参考：《皖南医学院》2016年硕士论文

【摘要】：目的:了解单侧唇裂手术方式及效果;了解单侧唇裂患儿家属因唇裂患儿唇裂畸形及抚养过程中造成的躯体及心理健康情况;了解单侧唇裂患儿家属对疾病的认知、手术修复的满意度;了解单侧唇裂术后合并鼻唇畸形Ⅱ期手术修复方式及效果;了解单侧唇裂术后合并鼻唇畸形Ⅱ期手术患者的性格状态及对疾病的认知、手术修复的满意度。这项研究的目的是对单侧唇裂Ⅰ期手术家属及Ⅱ期手术患者及家属进行全面的评价,为临床单侧唇裂乃至其他类型的唇裂及腭裂的治疗提供指导意见。方法:本研究病例均采集于皖南医学院第一附属医院整形科病房,时间自2005年至2015年十年间的单侧唇裂患者及单侧唇裂继发鼻唇畸形行二次修复的患者。筛选Ⅰ期单侧唇裂患儿16人,Ⅰ期患儿家属29人,对照组于社区选取健康儿童20名,家属37人;单侧唇裂术后合并鼻唇畸形Ⅱ期手术选取患者35人,对照组于社区选取健康男女青少年各20人。对于单侧唇裂患儿Ⅰ期手术采用自设问卷了解患者家属面对唇裂患儿时心理反应及术后满意度,采用焦虑自评量表(self rating anxiety scale,SAS)、90项症状清单(Symptom Checklist 90,SCL-90)问卷了解患儿家长心理状况及是否对身体产生相应影响;单侧唇裂术后合并鼻唇畸形Ⅱ期手术采用艾森克个性问卷(EPQ)评估患者个性,SCL-90问卷了解患者心理状况是否对身体产生相应影响,采用自设问卷了解患者术后满意度及生活质量。结果:Ⅰ期患儿采用恢复口轮匝肌解剖关系的术式均取得较好的效果,但Ⅰ期患儿家属在自设问卷、焦虑自评量表、90项症状清单都显示出异常,提示患儿家属存在明显的负性心理状态;Ⅱ期手术患者根据其继发畸形的不同情况选取不同的手术方式均能取得较好的效果,唇裂术后的患者在自设问卷、焦虑自评量表、90项症状清单及艾森克个性问卷中均显示出了异常,提示大多患者存在较明显的负性心理,此外Ⅱ期手术能部分改善患者的负性心理状态。结论:Ⅰ期患儿根据唇裂的严重程度选择恢复口轮匝肌解剖关系的术式,Ⅰ期患儿家属存在比较明显的负性心理,需要在患儿治疗时及后期持续的为家属提供社会支持及心理疏导;Ⅱ期手术根据畸形的不同手术方式可取得较好效果,唇裂患者往往存在较严重的负性心理状态,虽然手术可以缓解,但是持续的心理疏导与心理支持必不可少。
[Abstract]:Objective: to understand the operation mode and effect of unilateral cleft lip, to understand the physical and mental health of the family of the child with unilateral cleft lip caused by the cleft lip malformation and the process of upbringing, and to understand the cognition of the disease among the family members of the child with unilateral cleft lip. The satisfaction degree of surgical repair, the mode and effect of the second stage operation of unilateral cleft lip with nasolabial deformity, the personality state, the cognition of disease, the satisfaction of operation and repair of the patients with nasolabial deformity after unilateral cleft lip surgery were investigated. The purpose of this study is to evaluate the clinical treatment of unilateral cleft lip and other types of cleft lip and cleft palate. Methods: all the cases were collected from the Department of plastic surgery of the first affiliated Hospital of Southern Anhui Medical College. The patients with unilateral cleft lip and secondary nasolabial deformity of unilateral cleft lip were repaired from 2005 to 2015. A total of 16 children with unilateral cleft lip in stage I, 29 family members with stage I, 20 healthy children and 37 family members in the control group were selected from the community, 35 patients were selected for stage 鈪，

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