摘要
目的:了解心脏介入诊断、治疗前后冠心病患者的情绪障碍和心理干预的效果。
方法:以冠脉造影诊断及经皮冠状动脉介入治疗(PCI)治疗成功的冠心病患者52例和同期接受单纯药物治疗的冠心病患者52例为对象,随机分成对照组和治疗组,对照组仅进行常规药物治疗和冠心病常规护理;研究组在此基础上加抗焦虑、抑郁治疗,服用圣约翰草提取物(路优泰)300mg,早晚各1次,应用普适性量表——医学结局研究简短量表(SF-36)和冠心病专用量表——西雅图心绞痛调查问卷(SAQ)、综合性医院焦虑抑郁量表(HAD)调查患者在入院前1天,出院后3个月及出院后6个月的情绪障碍和生活质量。并测试血脂、空腹血糖、血压体重指数。
结果:1、心理干预后治疗组的情绪障碍较对照组明显改善(p<0.05)。生活质量量表得分治疗组明显高于对照组(p<0.05)。
2、PCI治疗组患者生活质量为出院后6个月>出院后3个月>入院前(P<0.05);药物治疗组患者的生活质量为出院后6个月>出院后3个月>入院前(P<0.05);PCI治疗组患者生活质量变化幅度高于药物治疗组患者的生活质量变化幅度。
3、血脂、血糖、血压、体重指数等指标,治疗组均低于对照组(p<0.05)
结论:1、抗焦虑、抑郁治疗能明显缓解冠心病患者的负性情绪,提高临床治疗效果,改善患者的生活质量及预后。
2、PCI手术可以显著提高冠心病患者的住院期间和出院后近期的生活质量。
Objective:To study disorder in patients with coronary heart disease (CHD) before and after the interventional therapy and to investigate the effect of mental intervention.
Methods:Fifty-two patients diagnosed by coronary angiography or cured by PCI were kept in PCI guoup while the drug therapy group contained Fifty-two patients cured by drug simply.All the patients were randomly allocated to treatment or control group.The control group was given routine medication and nursing,while the research group received anti-anxiety and depression treatment which use St John's wort (300mg Bid po)based on the routine medication and nursing。The quality of life and psychologic condition one day before hospitalization,the three month after discharge and six months after dischartge in both two groups were assessed by Medical Outcome Study Short Form-36(SF-36) and the Settle Angina Survey Form (SAQ)The Hospital Anxiety and Depression Scale (HAD),and tested the blood-fat, blood-fasting sugar,blood pressure,BMI.
Results:1.After the mental intervention,,compared with control group,the rate of anxiety and depression occurred and the quality of life have marked difference with the treatment group.
2.The quality of life in 6 mnths after discharge in PCI group was best while the quality of life before hospitalization was least(P<0.05).The drug therapy group show the same results (P<0.05).
3、the blood-fat,blood-fasting sugar,blood pressure,BMI lower than treatment group(p<0.05).
Conclusion:1.Anti-anxiety and depression treatment indeed can relieve the negative emotion of patients.improve the patients'quality of life.better the clinical effect and prognosis.
2、PCI can significantly improve the quality of life during hospitalization and in a short time after discharge in patients with CHD.
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