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首页> 外文期刊>Journal of psychosomatic research >Psychological and psychiatric aspects of face transplantation: Lessons learned from the long-term follow-up of six patients
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Psychological and psychiatric aspects of face transplantation: Lessons learned from the long-term follow-up of six patients

机译：面部移植的心理和精神方面：从六名患者的长期随访中汲取的经验教训

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摘要

Since 2005, at least 38 face transplantations have been performed worldwide. Available recommendations on psychological management are based on isolated cases or small case series, either not focused on mental health or with a short follow-up. We propose herein a clinical commentary on psychological and psychiatric outcomes from the follow-up of a prospective single-center cohort of six patients over a period of 3.5 to 9 years. Seven patients received a face transplant between January 2007 and April 2011: two patients with neurofibromatosis, four with self-inflicted ballistic trauma, one with self-immolation. One patient died at 63 days of cerebral sequelae from cardiac arrest in the setting of bacterial infection. The six other patients were routinely evaluated with unstructured psychological interviews up to May 2016 and with the Short Form 36-item health survey and the Mini-International Neuropsychiatric Interview at one year and at the end of the follow-up. Clinically meaningful observations were the following: a history of mental disorders before disfigurement was associated with poor physical and mental outcomes, including poor adherence and one suicide; untreated depression was associated with poor adherence; acceptance of the new face occurred rapidly and without significant distress in all of the patients; fear of transplant rejection was present to some degree in all of the patients and did not substantially differ from other transplantation settings; media exposure may be disturbing but may also have had positive psychological effects on some of the patients. Mental health issues related to chronic rejection and re-transplantation remain to be explored.
机译：自2005年以来，全世界至少进行了38人移植。关于心理管理的可用建议是基于孤立的病例或小案系列，无论是专注于心理健康还是短暂的随访。我们提出了在3.5至9年的前瞻性单中心队列的前瞻性单中心队列的后续行动的临床评论。 7名患者在2007年1月至2011年1月期间接受了脸部移植：两名神经纤维瘤病患者，四个具有自我造成的弹道创伤，一个具有自焚。一名患者在63天在细菌感染的情况下在心脏骤停中死亡。其他患者常规评估2016年5月至2016年5月的非结构化心理访谈，并在短期36项健康调查和迷你国际神经精神科访谈，并在一年内完成后续行动。临床上有意义的观察结果如下：伪造前的精神障碍史与差的身心结果有关，包括粘附性差和一个自杀;未经治疗的抑郁症与粘性差有关;接受新面孔的迅速发生，所有患者都没有显着困扰;对移植排斥的恐惧存在于所有患者的某种程度上，并且与其他移植环境没有显着不同;媒体曝光可能是令人不安的，但也可能对一些患者进行了积极的心理作用。与慢性拒绝和再移植相关的心理健康问题仍有待探索。

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