摘要
背景:冠状动脉旁路移植作为一个负性事件可引起冠状动脉粥样硬化性心脏病患者的心理应激反应。目的:观察冠状动脉旁路移植患者移植前后心理状态的变化,分析影响冠状动脉旁路移植患者心理变化的因素。方法:选取2007-01/2009-06于新疆医科大学第五附属医院心外科行冠状动脉旁路移植的患者82例,具备正常的认知能力,无慢性精神疾病史,理解力正常,无失语,自愿接受心理评估。于移植前1d、移植后出院前1d分别用中国版90项症状自评量表SCL-90对患者心理状况进行评价。结果与结论:冠状动脉旁路移植前总均分、阳性项目数、阳性症状均分、躯体化、抑郁、焦虑和恐怖因子分高于常模,人际关系敏感、偏执因子分低于常模,冠状动脉旁路移植后抑郁、焦虑较移植前高(P<0.05～0.01);其共同特点为冠状动脉旁路移植患者移植前、后存在明显的抑郁、焦虑心理。结果提示,抑郁和焦虑会增加冠状动脉旁路移植过程中、移植后心血管事件的危险,故在移植前、后应常规对患者进行心理状态评估,合理进行干预,降低移植过程中并发症的发生,减少冠状动脉旁路移植后心血管事件的发生。
BACKGROUND： As a negative event, coronary artery bypass grafting （CABG） can lead to psychological stress for patients with coronary atherosclerotic heart disease. OBJECTIVE： To explore the change of psychological status and their influencing factors prior to and after CABG in patients with coronary disease. METHODS： A total of 82 patients received CABG at the Department of Cardiovascular Surgery, Fifth Hospital Affiliated to Xinjiang Medical University, from January 2007 to June 2009, were selected. All patients had normal cognitive and comprehension ability, without mental disorder history, and agreed to join the follow up. The patients were examined by the Chinese version of Symptom Check List-90 （SCL-90） in a day before operation and in the day before leaving hospital. RESULTS AND CONCLUSION： Prior to CABG, the factorial scores of global severity index, positive symptoms severity index, somatization, depression, anxiety, phobic were higher than norm, and the scores were significantly decrease on interpersonal sensitivity and paranoid ideation. After the procedure, the depression and anxiety score were higher than that before operation （P 0.05-0.01）. The identical characteristics were that patients exhibited obviously depression and anxiety prior to and after operation. The depression and anxiety can increase side effects before and after CABG. The psychological state of the patients should be routinely assessed in the procedure, and at the same time the reasonable psychological intervention should be carried out, which can reduce the intraoperative complication and occurrence of cardiovascular events.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2010年第31期5833-5836,共4页
Journal of Clinical Rehabilitative Tissue Engineering Research
