Вираженість психоемоційного напруження на ситуаційний стрес у дітей із незрощенням піднебіння

Abstract

Представлені результати обстеження психоемоційного напруження в 37 дітей віком 4-5 років з уродженими незрощеннями піднебіння в умовах поліклінічного спостереження і безпосередньо перед оперативним втручанням. Ці стресорні ситуації негативно діють на організм, викликаючи зміни з боку серцево-судинної, дихальної і вегетативної нервової систем, ступінь вираженості яких залежить від рівня подразнювального фактора, навколишнього середовища і психологічної атмосфери в лікувальному закладі; Представлены результаты обследования психоэмоционального напряжения у 37 детей 4-5 лет с врожденными несращениями неба в условиях поликлинического наблюдения и непосредственно перед оперативным вмешательством. Эти стресорные ситуации негативно воздействуют на организм, вызывая изменения со стороны сердечно-сосудистой, дыхательной и вегетативной нервной систем, степень выра- жености которых зависит от уровня раздражающего фактора, окружающей обстановки и психологической атмосферы в лечебном учреждении; Numerous experimental studies and clinical observations indicates that in one and the same stress situations a human being and animals express a different resistance to emotional stress, the severity of which depends greatly on the individual characteristics of self-regulation of different body functional systems. Therefore, the stress factors affect homeostasis, activate the systems, responsible for adaptation in different life situations. The article is aimed to study of the severity of psycho-emotional tension in children with cleft palate, which occurs during the out-patient reception hours and right before the surgical intervention. Methods and Materials 37 children aged 4-5 years with cleft palate, who had out-patient reception hours and received treatment at the Surgical Unit of Poltava Children’s Municipal Clinical Hospital, have been involved into study. The examination was conducted in the clinical room in out- patient conditions and right before the surgical intervention prior to preanesthetic medication. 20 healthy children who were tested in relatively normal condition, as the procedure took place always in one and the same time of the day from 9 to 10 hours, have been assigned to the control group. Results and Discussion The outcomes of the Lüscher test established that 26 children (70,3%) demonstrated the high degree of anxiety, 7 children (18.9%) demonstrated medium degree of anxiety and 4 children (10.8%) demonstrated low degree of anxiety. Taking into account the prevalence of individuals with high degree of anxiety in the common group we selected them for the follow up in-depth examination. Generalization of the results concerning test indices, obtained during the examination of patients at the outpatient reception hours enabled to establish that the rates of the systolic and diastolic pressure increased insignificantly. At the same time the respiratory and pulse rate increased by 1,2 time and the vegetative index by 1,3 time. Hildebrandt’s coefficient and minute volume was tending to increase. Statistical processing of digital values, obtained in the same group of patients right before the surgical intervention prior to preanesthetic medication in Children's Surgical Unit showed the increase in the rates of arterial pressure by 1,2 times and respiratory and pulse rate by 1,4 and 1,3 times, respectively. Hildebrandt coefficient increased insignificantly, whereas the vegetative index and minute volume was higher by 1,2 and 1,5 times, respectively. Comparative analysis of the indices, particularly, the systolic and diastolic pressure, Hildebrandt’s coefficient and minute volume (р>0,05), obtained during the examination of children at the out-patient reception hours and at the hospital showed its progressive increase while staying at atypical psycho-emotional atmosphere of the Surgical Unit. At the same time the respiratory and pulse rate, as well as vegetative index increased by 1,2 time (p < 0.05). Thus, the findings indicate about the direct dependence of the severity degree of neurosis in children with congenital cleft palate from the power of the stress factor’s impact. Conclusions 1. Among children with apparent cleft palate, individuals with the high degree of anxiety (70,3%) prevailed; the medium degree of anxiety was detected in 18,9% of children, and the low degree of anxiety was found in 10,8% of children, which requires carrying out purposeful, individually oriented preanesthetic medication before surgical intervention. 2. Psycho-emotional tension in children with apparent cleft palate during the out-patient reception hours and before surgery is caused by the situational condition that adversely affects the body. At the same time changes in functional activity of the cardiovascular, respiratory and vegetative nervous system occur, the severity of which depends on the power of the stress factor’s impact.