永久性心脏起搏器植入术对患者生活质量及焦虑、抑郁的影响
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摘要
目的:探讨永久性心脏起搏器植入术对患者生活质量和情绪状态的影响,及术后生活质量和焦虑抑郁的影响因素。方法:选取拟接受永久性心脏起搏器植入术的患者共74例。使用健康调查表SF-36(Short-form-36Health Survey,SF-36)评估生活质量,采用抑郁自评量表(Self-Rating Depression Scale,SDS)和焦虑自评量表(SelfRating Anxiety Scale,SAS)评估焦虑抑郁状态。在完成起搏器植入术当天收集患者的一般资料及量表评分。于术后1月、6月程控时完成随访。结果:共64名患者完成全程随访。统计结果显示,患者术后生活质量较术前有较大提升,术后六个月生活质量明显优于术前(P<0.05),术后一月时除精力、情绪角色(P>0.05)外生活质量均优于术前(P<0.05)。术前后焦虑抑郁情绪无明显变化(P>0.05)。回归分析显示年龄、性别、血脂异常、糖尿病和心功能分级将影响术后生活质量和精神状态(P<0.05),而起搏模式、冠心病则无明显影响(P>0.05)。结论:植入永久性心脏起搏器将改善患者术后生活质量,高龄、女性、心功能差、合并血脂异常、糖尿病与术后较低水平的生活质量及焦虑抑郁相关。
Objective: To explore the effect of cardiac pacemaker implantation on the quality of life(QoL)、depression and anxiety in patients,and the influencing factors of QoL、depression and anxiety six months after implantation. Methods:A total of 74 patients who have been qualified for pacemaker implantation were selected. Using the Health Survey Form SF-36(SF-36) to assess the QoL, and the Self-Rating Anxiety Scale(SAS) and Self-Rating Depression Scale(SDS) to assess depression and anxiety. General data of patients were collected on the day of implantation. Follow-up was conducted in 1 and6 months after implantation. Results: A total of 64 patients were followed up. Increased QoL is observed six months after pacemaker implantation(P<0.05), so as one month after implantation(P<0.05), expect two — the"Vitality"and"Role emotional"area(P>0.05). There was no difference in SAS, SDS value before and after implantation(P>0.05). The analysis showed the negative correlation of Age, gender, dyslipidemia,diabetes and heart function with QoL、depression and anxiety(P<0.05). Moreover, pacing mode、family status and CHD did not correlate with QoL、depression and anxiety(P>0.05). Conclusion: Implanting a pacemaker improves QoL in patient with indication. Elder, female, poor heart function, in combination with dyslipidemia and diabetes patients may relate to poor QoL, depression and anxiety.
Objective: To explore the effect of cardiac pacemaker implantation on the quality of life(QoL)、depression and anxiety in patients,and the influencing factors of QoL、depression and anxiety six months after implantation. Methods:A total of 74 patients who have been qualified for pacemaker implantation were selected. Using the Health Survey Form SF-36(SF-36) to assess the QoL, and the Self-Rating Anxiety Scale(SAS) and Self-Rating Depression Scale(SDS) to assess depression and anxiety. General data of patients were collected on the day of implantation. Follow-up was conducted in 1 and6 months after implantation. Results: A total of 64 patients were followed up. Increased QoL is observed six months after pacemaker implantation(P<0.05), so as one month after implantation(P<0.05), expect two — the"Vitality"and"Role emotional"area(P>0.05). There was no difference in SAS, SDS value before and after implantation(P>0.05). The analysis showed the negative correlation of Age, gender, dyslipidemia,diabetes and heart function with QoL、depression and anxiety(P<0.05). Moreover, pacing mode、family status and CHD did not correlate with QoL、depression and anxiety(P>0.05). Conclusion: Implanting a pacemaker improves QoL in patient with indication. Elder, female, poor heart function, in combination with dyslipidemia and diabetes patients may relate to poor QoL, depression and anxiety.
引文
1乔青,徐伟.ACCF/AHA/HRS植入器械指南中普通起搏器植入适应证解读.中国介入心脏病学杂志,2014,9:611-612
2 Nakano Y,Shimizu W.Genetics of long-QT syndrome.Journal of Human Genetics,2016,61(1):51-55
3 Boriani G,Connors S,Kalarus Z,et al.Cardiac Resynchronization Therapy With a Quadripolar Electrode Lead Decreases Complications at 6 Months:Results of the MORE-CRTRandomized Trial.JACC Clinical Electrophysiology,2015,2(2):212-220
4戴研,陈柯萍,华伟,等.植入型心律转复除颤器临床应用现状(20家医院注册研究).中华心律失常学杂志,2017,21(1):26-30
5 Benzer W,Oldridge N,Monti MA,et al.Clinical predictors of health-related quality of life after pacemaker implantation.Wiener Klinische Wochenschrift,2006,118(23-24):739-743
6 M?ynarski R,W?odyka A,Kargul W.Changes in the mental and physical components of the quality of life for patients six months after pacemaker implantation.Cardiology Journal,2009,16(3):250-253
7 Eck JWMV,Hemel NMV,Kelder JC,et al.Poor HealthRelated Quality of Life of Patients with Indication for Chronic Cardiac Pacemaker Therapy.Pacing and Clinical Electrophysiology,2008,31(4):7
8 Udo EO,Hemel NMV,Zuithoff NPA,et al.Long term quality-of-life in patients with bradycardia pacemaker implantation.International Journal of Cardiology,2013,168(3):2159-2163
9张澍,华伟,黄德嘉,等.植入性心脏起搏器治疗--目前认识和建议(2010年修订版).中华心律失常学杂志,2011,14(11):245-259
10张代民,刘志华,郭涛,等.SF-36健康调查问卷在起搏器植入患者中的信度和效度评价.苏州大学学报:医学版,2007,27(5):777-779
11中国成人血脂异常防治指南修订联合委员会.中国成人血脂异常防治指南(2016年修订版).中国循环杂志,2016,16(10):15-35
12 Kjell RMD.The Early History of Cardiac Surgery in Stockholm.Journal of Cardiac Surgery,2010,18(6):564-572
13中国心血管病报告编写组.《中国心血管病报告2016》概要.中国循环杂志,2017,32(6):521-530
14 Speedie A,Mathew C,Shahi RS,et al.Long-term Mortality in Patients with Permanent Pacemaker Implantation.J Assoc Physicians India,2016,64(9):18-22
15 Kerr CR,Connolly SJ,Abdollah H,et al.Canadian Trial of Physiological Pacing:Effects of physiological pacing during long-term follow-up.Acc Current Journal Review,2004,13(5):65-65
16 Fleischmann KE,Orav EJ,Lamas GA,et al.Pacemaker implantation and quality of life in the Mode Selection Trial(MOST).Heart Rhythm the Official Journal of the Heart Rhythm Society,2006,3(6):653-659
17 Udo EO,Zuithoff NP,van Hemel NM,et al.Incidence and predictors of short-and long-term complications in pacemaker therapy:the FOLLOWPACE study.Heart Rhythm the Official Journal of the Heart Rhythm Society,2012,9(5):728-735
18 Dazhou L,Jinsheng W,Yan W,et al.Intervention study on anxiety and depression of patients with permanent pacemaker implanted.Journal of Jiangsu Practical Electrocardiology,2014
19黎云,余健,罗洪,等.永久人工心脏起搏器植入术患者焦虑抑郁调查分析.广东医学,2009,30(2):277-278
20 Mitro P,Kotianova A,Bodnar J,et al.Quality of life and psychological well-being in patients with various pacing modes.BratislavskéLekárske Listy,2008,109(6):260
21赵小静.起搏器植入患者社会支持、积极心理资本与生活质量的相关性研究.山东大学,2017
22 van Eck JW,van Hemel NM,Kelder JC,et al.Poor healthrelated quality of life of patients with indication for chronic cardiac pacemaker therapy.Pacing&Clinical Electrophysiology Pace,2008,31(4):480
23 Mandawat A,Curtis J P,Mandawat A,et al.Safety of pacemaker implantation in nonagenarians:an analysis of the healthcare cost and utilization project-nationwide inpatient sample.Circulation,2013,127(14):1453
24 Mitro P,Kotianova A,Bodnar J,et al.Quality of life and psychological well-being in patients with various pacing modes.BratislavskéLekárske Listy,2008,109(6):260
25畅君毅,闫吉霞,苏伟民.长期右室单腔起搏与双腔起搏对心律失常患者生活质量的影响.临床心身疾病杂志,2017,23(4):3
2 Nakano Y,Shimizu W.Genetics of long-QT syndrome.Journal of Human Genetics,2016,61(1):51-55
3 Boriani G,Connors S,Kalarus Z,et al.Cardiac Resynchronization Therapy With a Quadripolar Electrode Lead Decreases Complications at 6 Months:Results of the MORE-CRTRandomized Trial.JACC Clinical Electrophysiology,2015,2(2):212-220
4戴研,陈柯萍,华伟,等.植入型心律转复除颤器临床应用现状(20家医院注册研究).中华心律失常学杂志,2017,21(1):26-30
5 Benzer W,Oldridge N,Monti MA,et al.Clinical predictors of health-related quality of life after pacemaker implantation.Wiener Klinische Wochenschrift,2006,118(23-24):739-743
6 M?ynarski R,W?odyka A,Kargul W.Changes in the mental and physical components of the quality of life for patients six months after pacemaker implantation.Cardiology Journal,2009,16(3):250-253
7 Eck JWMV,Hemel NMV,Kelder JC,et al.Poor HealthRelated Quality of Life of Patients with Indication for Chronic Cardiac Pacemaker Therapy.Pacing and Clinical Electrophysiology,2008,31(4):7
8 Udo EO,Hemel NMV,Zuithoff NPA,et al.Long term quality-of-life in patients with bradycardia pacemaker implantation.International Journal of Cardiology,2013,168(3):2159-2163
9张澍,华伟,黄德嘉,等.植入性心脏起搏器治疗--目前认识和建议(2010年修订版).中华心律失常学杂志,2011,14(11):245-259
10张代民,刘志华,郭涛,等.SF-36健康调查问卷在起搏器植入患者中的信度和效度评价.苏州大学学报:医学版,2007,27(5):777-779
11中国成人血脂异常防治指南修订联合委员会.中国成人血脂异常防治指南(2016年修订版).中国循环杂志,2016,16(10):15-35
12 Kjell RMD.The Early History of Cardiac Surgery in Stockholm.Journal of Cardiac Surgery,2010,18(6):564-572
13中国心血管病报告编写组.《中国心血管病报告2016》概要.中国循环杂志,2017,32(6):521-530
14 Speedie A,Mathew C,Shahi RS,et al.Long-term Mortality in Patients with Permanent Pacemaker Implantation.J Assoc Physicians India,2016,64(9):18-22
15 Kerr CR,Connolly SJ,Abdollah H,et al.Canadian Trial of Physiological Pacing:Effects of physiological pacing during long-term follow-up.Acc Current Journal Review,2004,13(5):65-65
16 Fleischmann KE,Orav EJ,Lamas GA,et al.Pacemaker implantation and quality of life in the Mode Selection Trial(MOST).Heart Rhythm the Official Journal of the Heart Rhythm Society,2006,3(6):653-659
17 Udo EO,Zuithoff NP,van Hemel NM,et al.Incidence and predictors of short-and long-term complications in pacemaker therapy:the FOLLOWPACE study.Heart Rhythm the Official Journal of the Heart Rhythm Society,2012,9(5):728-735
18 Dazhou L,Jinsheng W,Yan W,et al.Intervention study on anxiety and depression of patients with permanent pacemaker implanted.Journal of Jiangsu Practical Electrocardiology,2014
19黎云,余健,罗洪,等.永久人工心脏起搏器植入术患者焦虑抑郁调查分析.广东医学,2009,30(2):277-278
20 Mitro P,Kotianova A,Bodnar J,et al.Quality of life and psychological well-being in patients with various pacing modes.BratislavskéLekárske Listy,2008,109(6):260
21赵小静.起搏器植入患者社会支持、积极心理资本与生活质量的相关性研究.山东大学,2017
22 van Eck JW,van Hemel NM,Kelder JC,et al.Poor healthrelated quality of life of patients with indication for chronic cardiac pacemaker therapy.Pacing&Clinical Electrophysiology Pace,2008,31(4):480
23 Mandawat A,Curtis J P,Mandawat A,et al.Safety of pacemaker implantation in nonagenarians:an analysis of the healthcare cost and utilization project-nationwide inpatient sample.Circulation,2013,127(14):1453
24 Mitro P,Kotianova A,Bodnar J,et al.Quality of life and psychological well-being in patients with various pacing modes.BratislavskéLekárske Listy,2008,109(6):260
25畅君毅,闫吉霞,苏伟民.长期右室单腔起搏与双腔起搏对心律失常患者生活质量的影响.临床心身疾病杂志,2017,23(4):3
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