围手术期心理干预对肺减容手术治疗晚期慢性阻塞性肺疾病的影响

目的 探讨围手术期心理干预对肺减容手术(LVRS)治疗晚期慢性阻塞性肺疾病(COPD)的影响.方法 对40例需接受LVRS的COPD患者的围手术期心理问题进行调查,并将患者分成干预组和对照组,所有患者均接受LVRS,干预组增加心理干预,以汉密尔顿焦虑量表(HAMA)和汉密尔顿抑郁量表(HAMD)评分作为干预效果的评价指标.结果 两组患者的抑郁、焦虑水平在入院时差异无显著性意义(P＞0.05);两组患者中,术前存在焦虑、抑郁(评分≥7)的患者,焦虑、抑郁水平在手术后6个月均有显著降低(P＜0.05);干预组的抑郁评分下降幅度较对照组大(P＜0.05).结论 COPD患者通过接受LVRS治疗,可明显改善抑郁及焦虑情绪;而在围手术期对患者进行心理干预,则能达到更好的效果,更有利于提高患者术后的生活质量.

Effect of Perioperatively Psychological Intervention on the COPD Patients Undergoing LVRS

Objective To investigate the effect of perioperatively psychological intervention on the advanced COPD patients who received lung volume reduction surgery(LVRS).Methods Forty COPD patients were divided into intervention group and control group.All the patients received LVRS,and the psychological intervention was given in the intervention group.The scales of Hamilton anxiety(HAMA) and Hamilton depression(HAMD) served as the indicators to evaluate the intervention effects.Results No significant difference in the anxious and depress levels was found between two groups at the admission(P>0.05).LVRS significantly reduced the HAMA and HAMD scores of all the patients(P<0.05).The intervention group had a more significant decline of the HAMA and HAMD scores than the control group(P<0.05).Conclusion The LVRS significantly improved the anxious and depress condition of the patients with COPD.The psychological intervention could improve the effect of LVRS,and the life quality of the patients.