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【目的】分析甲状腺激素替代治疗后的学龄前先天性甲状腺功能减低症(congenital hypothyroidism,CH)患儿的行为问题及其影响因素,以减少行为问题,提高患儿生存及生活质量。【方法】选取青岛市经新生儿筛查确诊的永久性CH患儿(病例组)47例及性别、年龄与之相匹配的正常儿童58例作为研究对象,采用自制的一般情况调查问卷、3~7岁儿童气质量表、Achenbach儿童行为量表以及家庭环境量表-中文版(FES-CV)进行调查分析。【结果】1)病例组行为问题发生率显著高于对照组。男童在忧郁、性问题、分裂样焦虑和违纪等四个因子得分均显著高于对照组男童;女童在体诉、忧郁、肥胖、攻击行为和多动等五个因子得分明显高于对照组女童。2)气质类型、家庭环境是影响CH患儿行为问题的重要因素。【结论】在对CH患儿进行甲状腺激素替代治疗的同时,应及时进行心理评估及咨询、解决其成长中出现的问题,使CH患儿全面健康发展。
【Objective】 To analyze the behavioral problems and its influencing factors in children with congenital hypothyroidism (CH) after thyroid hormone replacement therapy to reduce behavioral problems and improve their survival and quality of life. 【Methods】 Forty-seven permanent CH patients (case group) diagnosed by neonatal screening in Qingdao City and 58 normal children of the same age and sex were selected as research subjects. ~ 7-year-old children’s temperament scale, Achenbach children’s behavior scale and family environment scale - Chinese version (FES-CV) for investigation and analysis. 【Results】 1) The incidence of behavioral problems in case group was significantly higher than that in control group. Boys scored significantly higher than boys in the control group in terms of melancholy, sexual problems, schizoid anxiety and discipline. The scores of five factors including body weight, depression, obesity, aggression and hyperactivity were significantly higher in boys than in controls Girls group. 2) temperament type, family environment is an important factor affecting children with behavioral problems CH. 【Conclusions】 In the process of thyroid hormone replacement therapy for CH children, psychological assessment and counseling should be carried out in time to solve the problems in their growth so that CH children develop in an all-round and healthy way.