摘要
目的：研究腰椎间盘突出症（LDH）患者围手术期心理变化及干预效果。方法：对90例LDH择期拟行手术治疗的患者,术前使用症状自评量表（SCL-90）评估其心理状况,按照评估结果按1：1随机分组,对照组给予围手术期常规治疗,干预组在对照组基础上,围手术期使用SCL-90评估心理变化并采取对症心理干预治疗,比较两组效果。结果：LDH患者术前SCL-90因子包括人际敏感（t=3.98,P〈0.01）、精神病性（t=3.45,P〈0.01）、躯体化（t=26.55,P〈0.01）、强迫（t=4.96,P〈0.01）、焦虑（t=23.33,P〈0.01）、抑郁（t=11.18,P〈0.01）、恐怖（t=4.86,P〈0.01）、敌对（t=3.83,P〈0.01）和偏执（t=4.06,P〈0.01）评分均显著高于全国常模;术前人际敏感80%,精神病性53.33%,躯体化97.78%,强迫86.67%,焦虑100%,抑郁83.33%,恐怖77.78%,敌对64.44%,偏执71.11%;术后,干预组SCL-90各因子评分均显著低于对照组（t=2.76,2.32,8.47,2.43,7.74,4.25,2.37,2.10,2.53;P〈0.05）;两组术后1d和3个月,VAS评分较术前显著降低（t_（干预）=35.32,44.01;P〈0.01;t对照=31.30,40.11;P〈0.01）,两组术后1d差异显著（t=2.40,P〈0.05）;干预组优良率97.78%,对照组91.11%,差异不显著（P〉0.05）。结论：腰椎间盘突出症患者围手术期存在较为严重的心理症状,采取心理干预治疗后,可明显改善患者心理症状和增加患者疼痛耐受性。
Objective： To study the perioperative psychological changes and intervention effects in patients with lumbar disc herniation（LDH）.Methods：The psychological status of 90 LDH patients who were going to receive elective surgery was evaluated with the SCL-90 scale before surgery,and according to the evaluation results, the patients were equally divided into the control group and the intervention group.The control group was given LDH perioperative treatment, while the intervention group was given symptomatic psychological intervention and perioperative psychological changes were evaluated with the SCL- 90 scale. Results： The scores of SCL- 90 factors of LDH patients before surgery,including interpersonal sensitivity（t =3.98,P〈0.01） ,psychoticism（t =3.45 ,P〈0.01） ,somatization（t =26.55 ,P〈0.01）, compulsion（t =4.96 ,P〈0.01）, anxiety（t = 23.33 ,P〈0.01）, depression（t = 11.18 ,P〈 0.01） ,terror（t =4.86, P 〈0.01）, hostility（t = 3.83, P〈0.01 ） and paranoid （t = 4.06, P 〈0.01） were significantly higher than the national norm. Before surgery, the percentages of interpersonal sensitivity, psyehoticism, somatization,compulsion, anxiety, depression, terror, hostility and paranoid were 80%, 53.33%, 97.78%, 86.67%, 100%, 83.33 %, 77.78 %, 64.44 % and 71.11%, respectively.After surgery, the scores of SCL- 90 factors were significantly lower in the intervention group than that in the control group（t = 2.76,2.32,8.47,2.43,7.74,4.25,2.37,2.10.2.53, P 〈0.05）.1 day and 3 months after surgery,VAS scores of the two groups were significantly lower than those before surgery（ tinterventio= 35.32,44.01, P 〈 0.01, t control = 31.30,40.11, P 〈0.01 ）.There were significant differences between the two groups at 1 day after surgery（t =2.40,P〈0.05）.The excellent and good rate in the intervention group was 97.78%,and it was 91.11% in the control group（P〉0.05）.Conclusion：Patients with LDH have more serious adverse psychological symptoms in perioperative period,
作者
王锦
WANG Jin(Xinyang Central Hospital, Xinyang 464000, Chin)
出处
《中国健康心理学杂志》
2018年第3期337-341,共5页
China Journal of Health Psychology
