直立倾斜试验受试儿童心理恐惧的评估  

Evaluation of psychological fear in children undergoing head-up tilt test

作　　者：储卫红[1,2] 吴礼嘉[1,2] 王成[1,2] 林萍[1,2] 李芳[1,2] 祝立平[1,2] 冉静[1,2] 邹润梅[1,2] 刘德宇[1,2] 

机构地区：[1]中南大学湘雅二医院儿童医学中心儿童心血管专科 [2]中南大学儿科学研究所,湖南长沙410011

出　　处：《中国当代儿科杂志》2014年第3期263-267,共5页Chinese Journal of Contemporary Pediatrics

基　　金："十二五"国家科技支撑计划(2012BAI03B03);湖南省自然科学基金项目(13JJ5014);湖南省卫生厅课题(B2013-013)

摘　　要：目的探讨直立倾斜试验（HUTT）的不同倾斜角度及不同试验反应对受试儿童心理恐惧的影响。方法不明原因晕厥或先兆晕厥儿童107例，年龄5．5～17．8（12．0±2．8）岁，男52例，女55例，随机选取60°、70°或80°进行基础直立倾斜试验（BHUT），BHUT阴性者保持同一倾斜角度进行舌下含化硝酸甘油倾斜试验（SNHUT）。采用Wong-Baker面部表情疼痛量表，在试验结束时让受试儿童对HUTT过程中心理恐惧程度进行自我评定。结果倾斜角度为60°、70°、80°的3组受试儿童HUTT阳性率、血流动力学改变、反应类型分布差异均未见统计学意义（P〉0．05）。60°、70°、80°3种倾斜角度对受试儿童心理恐惧程度的影响呈递增趋势，但差异无统计学意义（P〉0．05）。HUTT阳性儿童（n=76）心理恐惧程度明显高于HUTT阴性儿童（n=31）（P〈0．01）。结论HUTT可引起受试儿童心理恐惧；60°、70°、80°3种倾斜角度受试儿童心理恐惧呈递增趋势，但差异不显著；HUTT阳性反应可显著增加受试儿童心理恐惧。Objective To investigate the effects of different tilt angles of head-up tilt test （HUTT） and different responses to HUTT on the psychological fear in children undergoing the test. Methods HUTT was performed on children with unexplained syncope or pre-syncope （107 cases： 52 males and 55 females）, aged 5.5-17.8 years （mean 12.0-2.8 years）. All subjects were randomly assigned to undergo HUTT at an angle of 60°, 70° or 80°; the negative cases underwent sublingual nitroglycerin-provocation HUTT at the same tilt angle. The Wong-Baker Faces Pain Rating Scale was used for self-assessment of psychological fear in subjects during HUTT at the end point of the test. Results The positive rate, hemodynamic changes and distribution of response types showed no significant differences between children at tilt angles of 60°, 70° and 80° （P〉0.05）. The greater the tilt angle, the higher the degree of psychological fear in children undergoing the test, but there were no significant differences between them （P〉0.05）. The degree of psychological fear in children who showed a positive response to HUTT （n=76） was significantly higher than that in children who showed a negative response （n=31） （P〈0.01）. Conclusions HUTT can cause psychological fear in children undergoing the test, and the degree of psychological fear increases in children tested at tilt angles from 60° to 80°, hut the differences have no statistical significance. A positive response to HUTT can significantly increase the psychological fear in children.

关 键 词：直立倾斜试验 倾斜角度 心理恐惧 儿童 

分 类 号：R725.4[医药卫生—儿科]