心理护理干预对无抽搐电休克治疗精神障碍患者心律失常发生情况的影响
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摘要
目的:探讨心理护理干预在预防无抽搐电休克治疗(modified electroconvulsive therapy,MECT)精神障碍患者过程中发生心律失常的效果。方法:搜集笔者所在医院2016年1月-2018年10月行无抽搐电休克治疗的住院患者256例,按入组先后顺序分为观察组和对照组,各128例。对照组给予常规精神病护理,观察组在常规精神病护理的基础上结合心理护理。结果:MECT开始后30 min内心律失常发生率为16.02%(41/256),包括频发室性早搏14例,室性二联律8例,室性三联律4例,室性心动过速7例,QTc间期延长7例,心脏骤停1例。其中MECT开始后5 min内心脏不良事件发生率为13.28%(34/256)。观察组心律失常发生率低于对照组,差异有统计学意义(P<0.05)。结论:联合心理护理能降低MECT过程中心律失常的发生率,提高治疗安全性,值得临床推广使用。
Objective:To explore the effect of psychological nursing intervention on preventing arrhythmia in mental disorders during the treatment of modified electroconvulsive therapy.Method:A retrospective analysis was performed on 256 inpatients who received modified electroconvulsive therapy in our hospital from January 2016 to October 2018,they were divided into observation group and control group in sequential order,128 cases in each group.The control group was given routine psychiatric nursing,the observation group was combined with psychological nursing on the basis of routine psychiatric nursing.The incidence of arrhythmia was compared between the two groups.Result:The proportion of arrhythmias occurred within 30 min after the start of MECT was16.02%(41/256),including 14 cases of frequent ventricular premature beat,8 cases of ventricular bigeminy,4 cases of ventricular trigeminy,7 cases of ventricular tachycardia,7 cases of prolongation of QTc interval,and 1 case of cardiac arrest.Among them,the incidence rate of adverse cardiac events within5 min after the start of MECT was 13.28%(34/256).The rate of arrhythmia in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion:Combined psychological nursing can reduce the incidence of arrhythmia in the process of MECT and improve the safety of treatment,which is worthy of clinical application.
Objective:To explore the effect of psychological nursing intervention on preventing arrhythmia in mental disorders during the treatment of modified electroconvulsive therapy.Method:A retrospective analysis was performed on 256 inpatients who received modified electroconvulsive therapy in our hospital from January 2016 to October 2018,they were divided into observation group and control group in sequential order,128 cases in each group.The control group was given routine psychiatric nursing,the observation group was combined with psychological nursing on the basis of routine psychiatric nursing.The incidence of arrhythmia was compared between the two groups.Result:The proportion of arrhythmias occurred within 30 min after the start of MECT was16.02%(41/256),including 14 cases of frequent ventricular premature beat,8 cases of ventricular bigeminy,4 cases of ventricular trigeminy,7 cases of ventricular tachycardia,7 cases of prolongation of QTc interval,and 1 case of cardiac arrest.Among them,the incidence rate of adverse cardiac events within5 min after the start of MECT was 13.28%(34/256).The rate of arrhythmia in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion:Combined psychological nursing can reduce the incidence of arrhythmia in the process of MECT and improve the safety of treatment,which is worthy of clinical application.
引文
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[7]石丽杰,张威,庞娜,等.无缝隙护理在无抽搐电休克治疗中的效果研究[J].实用临床医药杂志,2017,21(22):127-128.
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[11]张泽健.无抽搐电休克治疗精神病患者的麻醉体会[J].中外健康文摘,2011,8(36):55-56.
[12]黄健强,黎雪松,黄炜,等.无抽搐电休克治疗前后Q-Tc、Q-Tcd的变化及其临床意义[J].四川精神卫生,2015,28(1):36-38.
[2]任艳萍,姜玮,李艳茹,等.不同刺激电量无抽搐电痉挛治疗抑郁发作的疗效及不良反应比较[J].中华行为医学与脑科学杂志,2016,25(8):713-717.
[3]李丽娟,胡瑶,吴彦.无抽搐电休克治疗引起迟发性室上性心动过速一例报告分析[J].上海医药,2018,39(11):40-41.
[4]陈志峰.手术室麻醉苏醒护理对减少腹部手术患者全麻苏醒期躁动的疗效评价[J].护士进修杂志,2013,28(20):1884-1886.
[5]朱园,张燕红,王兆芹,等.无抽搐电痉挛治疗的护理[J].全科护理,2014,12(14):1296-1297.
[6]王海红.对进行无抽搐电休克治疗的难治性抑郁症患者实施全程优质护理的效果探究[J].当代医药论丛,2018,16(3):266-267.
[7]石丽杰,张威,庞娜,等.无缝隙护理在无抽搐电休克治疗中的效果研究[J].实用临床医药杂志,2017,21(22):127-128.
[8]陆再英,钟南山主编.内科学[M].第7版.北京:人民卫生出版社,2008:204-211.
[9]Koga Y,Mishima Y,Momozaki M,et al.A case of nonsustained ventricular tachycardia immediately following modified electroconvulsive therapy in a depressive patient[J].J Anesth,2011,25(4):595-598.
[10]杨文丽,武克文,张玉涛.影响MECT治疗疗程的原因分析[J].国际医药卫生导报,2014,20(11):1625-1627.
[11]张泽健.无抽搐电休克治疗精神病患者的麻醉体会[J].中外健康文摘,2011,8(36):55-56.
[12]黄健强,黎雪松,黄炜,等.无抽搐电休克治疗前后Q-Tc、Q-Tcd的变化及其临床意义[J].四川精神卫生,2015,28(1):36-38.