冠状动脉粥样硬化性心脏病患者精神状态评估及干预对疾病的影响
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摘要
目的探讨冠状动脉粥样硬化性心脏病(冠心病)患者的精神状态评估及干预对疾病的影响。方法选取2010年4月—2013年12月在成飞医院诊治的冠心病患者320例进行精神状态评估,对筛选出的162例精神状态异常患者随机分为对照组、心理干预组和治疗组,各54例。对照组采用常规临床治疗,心理干预组在对照组基础上实施心理干预,治疗组在心理干预的基础上加用镇静药物。观察3组患者治疗后的精神状态评分及住院时间。结果抑郁自评量表(SDS)和焦虑自评量表(SAS)评分治疗组、心理干预组均低于对照组,差异有统计学意义(P<0.05),且治疗组评分低于心理干预组,差异有统计学意义(P<0.05)。治疗组总有效率高于心理干预组和对照组,差异有统计学意义(P<0.05)。治疗组、心理干预组住院时间短于对照组,差异有统计学意义(P<0.05),且治疗组住院时间短于心理干预组,差异有统计学意义(P<0.05)。结论对冠心病患者进行积极精神状态评估,采取及时的干预,合理使用抗精神药物,可明显改善焦虑和抑郁情绪,提高临床疗效。
Objective To explore the influence of mental state evaluation and intervention on patients with coronary atherosclerotic cardiopathy. Methods Three hundred and twenty patients with coronary atherosclerotic cardiopathy treated in Chengfei Hospital from Apr. 2010 to Dec. 2013 were selected for assessing their mental state,in which 162 screened patients with abnormal mental state were randomly divided into control group,psychological intervention group and treatment group,54 cases in each group. Patients in control group were given routine clinical treatment,and based on that,patients in psychological intervention group were conducted with psychological intervention. Patients in treatment group were added with sedative based on psychological intervention group. The mental state and length of stay of 3 groups were observed. Results Self- Rating Depression Scale( SDS) score and Self- Rating Anxiety Scale( SAS) score were lower in treatment group and psychological intervention group than those in control group( P < 0. 05),were lower in treatment group than in psychological intervention group( P < 0. 05). The total effective rate was higher in treatment group than that in psychological intervention group and control group( P < 0. 05). The length of stay was shorter in treatment group and psychological intervention group than that in control group( P < 0. 05),was shorter in treatment group than that in psychological intervention group( P < 0. 05). Conclusion Positive mental state assessment,timely intervention,rational use of antidepressant drugs for patients with coronary atherosclerotic cardiopathy can obviously improve anxiety and depression of patients and enhance the clinical efficacy.
Objective To explore the influence of mental state evaluation and intervention on patients with coronary atherosclerotic cardiopathy. Methods Three hundred and twenty patients with coronary atherosclerotic cardiopathy treated in Chengfei Hospital from Apr. 2010 to Dec. 2013 were selected for assessing their mental state,in which 162 screened patients with abnormal mental state were randomly divided into control group,psychological intervention group and treatment group,54 cases in each group. Patients in control group were given routine clinical treatment,and based on that,patients in psychological intervention group were conducted with psychological intervention. Patients in treatment group were added with sedative based on psychological intervention group. The mental state and length of stay of 3 groups were observed. Results Self- Rating Depression Scale( SDS) score and Self- Rating Anxiety Scale( SAS) score were lower in treatment group and psychological intervention group than those in control group( P < 0. 05),were lower in treatment group than in psychological intervention group( P < 0. 05). The total effective rate was higher in treatment group than that in psychological intervention group and control group( P < 0. 05). The length of stay was shorter in treatment group and psychological intervention group than that in control group( P < 0. 05),was shorter in treatment group than that in psychological intervention group( P < 0. 05). Conclusion Positive mental state assessment,timely intervention,rational use of antidepressant drugs for patients with coronary atherosclerotic cardiopathy can obviously improve anxiety and depression of patients and enhance the clinical efficacy.
引文
[1]李育红,周建芝,闫晓宾.心理干预对冠心病患者焦虑情绪的影响研究[J].中国健康心理学杂志,2010,18(9):1044.
[2]Ranjith N,Pegoraro RJ,Rom L,et al.Causal mechanism for atherosclerosis or coronary heart disease in women:a constellation of components[J].Maturitas,2010,65(4):404.
[3]徐威,张春霞.护理心理干预对冠心病择期介入患者焦虑抑郁的影响[J].中国循证心血管医学杂志,2014,6(4):448.
[4]马跃文,刘畅.心脏康复对于冠心病患者抑郁、焦虑情绪改善的研究进展[J].中国康复理论与实践,2012,18(2):141.
[5]Gallagher R,Trotter R,Donoghue J.Preprocedural concerns and anxiety assessment in patients undergoing coronary angiography and percutaneous coronary interventions[J].Eur J Cardiovasc Nurs,2010,9(1):38.
[6]Trotter R,Gallagher R,Donoghue J.Anxiety in patients undergoing percutaneous coronary interventions[J].Heart Lung,2011,40(3):185.
[7]Zafar MU,Paz-Yepes M,Shimbo D,et al.Anxiety is a better predictor of platelet reactivity in coronary artery disease patients than depression[J].Eur Heart J,2010,31(13):1573.
[8]Figueredo V M.The time has come for physicians to take notice:the impact of psychosocial stressors on the heart[J].Am J Med,2009,122(8):704.
[9]李芬.冠心病患者择期介入治疗前后焦虑抑郁的心理干预[J].心血管康复医学杂志,2012,21(4):358.
[10]陈时爱.完善个性化心理护理对冠心病患者焦虑和抑郁情绪的影响[J].中国医学创新,2012,9(16):65.
[11]赵鹏,王艳娉.心血管疾病合并心理障碍的临床治疗效果[J].中国医药指南,2013,11(4):425.
[12]肖继明,徐军,缪东培.冠心病患者伴焦虑抑郁的心理干预[J].医学研究生学报,2011,24(9):927.
[13]蒋义生.冠心病伴焦虑抑郁的诊治进展[J].国际精神病学杂志,2012,39(2):111.
[14]马骏,刘同涛,贾崇奇.冠心病患者焦虑抑郁情绪及影响因素分析[J].中国公共卫生,2010,26(5):555.
[15]Einvik G,Dammen T,Omland T.Depression and cardiovascular disease is there an association[J].Tidsskkr Nor Laegeforen,2010,130(7):729.
[2]Ranjith N,Pegoraro RJ,Rom L,et al.Causal mechanism for atherosclerosis or coronary heart disease in women:a constellation of components[J].Maturitas,2010,65(4):404.
[3]徐威,张春霞.护理心理干预对冠心病择期介入患者焦虑抑郁的影响[J].中国循证心血管医学杂志,2014,6(4):448.
[4]马跃文,刘畅.心脏康复对于冠心病患者抑郁、焦虑情绪改善的研究进展[J].中国康复理论与实践,2012,18(2):141.
[5]Gallagher R,Trotter R,Donoghue J.Preprocedural concerns and anxiety assessment in patients undergoing coronary angiography and percutaneous coronary interventions[J].Eur J Cardiovasc Nurs,2010,9(1):38.
[6]Trotter R,Gallagher R,Donoghue J.Anxiety in patients undergoing percutaneous coronary interventions[J].Heart Lung,2011,40(3):185.
[7]Zafar MU,Paz-Yepes M,Shimbo D,et al.Anxiety is a better predictor of platelet reactivity in coronary artery disease patients than depression[J].Eur Heart J,2010,31(13):1573.
[8]Figueredo V M.The time has come for physicians to take notice:the impact of psychosocial stressors on the heart[J].Am J Med,2009,122(8):704.
[9]李芬.冠心病患者择期介入治疗前后焦虑抑郁的心理干预[J].心血管康复医学杂志,2012,21(4):358.
[10]陈时爱.完善个性化心理护理对冠心病患者焦虑和抑郁情绪的影响[J].中国医学创新,2012,9(16):65.
[11]赵鹏,王艳娉.心血管疾病合并心理障碍的临床治疗效果[J].中国医药指南,2013,11(4):425.
[12]肖继明,徐军,缪东培.冠心病患者伴焦虑抑郁的心理干预[J].医学研究生学报,2011,24(9):927.
[13]蒋义生.冠心病伴焦虑抑郁的诊治进展[J].国际精神病学杂志,2012,39(2):111.
[14]马骏,刘同涛,贾崇奇.冠心病患者焦虑抑郁情绪及影响因素分析[J].中国公共卫生,2010,26(5):555.
[15]Einvik G,Dammen T,Omland T.Depression and cardiovascular disease is there an association[J].Tidsskkr Nor Laegeforen,2010,130(7):729.