Clerici Carlo Alfredo, Ferrari Andrea, Luksch Roberto, Casanova Michela, Massimino Maura, Cefalo Graziella, Terenziani Monica, Spreafico Filippo, Polastri Daniela, Mapelli Sergio, Daolio Primo, Bellani Franca Fossati
Pediatric Oncology Unit, Istituto Nazionale dei Tumori, Milan, Italy.
Tumori. 2004 Jul-Aug;90(4):399-404. doi: 10.1177/030089160409000407.
Amputation surgery in pediatric patients suffering from malignant tumors is less common than in the past, but has a great emotional impact on patients and their families as well as on the medical team. Studies addressing the psychological aspects of limb amputation in childhood cancer are still relatively limited, and the results have sometimes been contradictory.
At the Pediatric Oncology Unit of the Istituto Nazionale Tumori of Milan psychological support was provided to candidates for amputation and their families, involving medical oncologists, a clinical psychologist, and social assistants. Twenty-two patients were analyzed and 16 underwent mutilating surgery.
Different emotional reactions were observed. Surgery proved to be easier to accept when the tumor caused pain and functional loss. Specialist medical psychological support was needed in case of defense mechanisms (eg, splitting and projection) and depressive reactions evolving into isolation or intolerance.
The reported experience could be helpful in providing adequate support to children with tumors requiring mutilating surgery.
与过去相比，患有恶性肿瘤的儿科患者进行截肢手术的情况已不那么常见，但这对患者及其家属以及医疗团队都产生了巨大的情感影响。针对儿童癌症患者肢体截肢心理方面的研究仍然相对有限，且结果有时相互矛盾。
在米兰国立肿瘤研究所的儿科肿瘤科，为截肢候选人及其家属提供心理支持，团队成员包括医学肿瘤学家、临床心理学家和社会助理。对22名患者进行了分析，其中16人接受了致残手术。
观察到不同的情绪反应。当肿瘤引起疼痛和功能丧失时，手术被证明更容易被接受。在出现防御机制（如分裂和投射）以及抑郁反应演变为孤立或不容忍的情况下，需要专业的医学心理支持。
所报告的经验可能有助于为需要进行致残手术的肿瘤患儿提供充分的支持。
