冠心病患者介入治疗前后焦虑抑郁障碍的心理干预与评价

Objective To discuss the effect of psychological intervention of depression in coronary heart disease after percutaneous coronary intervention (PCI). Methods The depression of 105 cases of coronary heart disease after PCI treatment was investigated. One hundred and five patients were randomly divided into intervention group and control group. The patientsin intervention group were treated with psychological intervention before and after PCI. The patients in control group were treated with normal treatment. Results There was not significant difference of incidence of depression an self-rating depression scale score between two groups. The depression in intervention group was less severe than that in control group ( P ＜ 0.01 ). Multivariate analysis showed: education level, the recent negative life events, household income, length of stay and sequelae of catheter intervention had significantly correlated with depression in coronary heart disease. Conclusion Psychological intervention can reduce the ratio of depression in coronary heart disease after PCI.     

冠心病患者介入治疗前后焦虑抑郁障碍的心理干预与评价

Objective To discuss the effect of psychological intervention of depression in coronary heart disease after percutaneous coronary intervention (PCI). Methods The depression of 105 cases of coronary heart disease after PCI treatment was investigated. One hundred and five patients were randomly divided into intervention group and control group. The patientsin intervention group were treated with psychological intervention before and after PCI. The patients in control group were treated with normal treatment. Results There was not significant difference of incidence of depression an self-rating depression scale score between two groups. The depression in intervention group was less severe than that in control group ( P ＜ 0.01 ). Multivariate analysis showed: education level, the recent negative life events, household income, length of stay and sequelae of catheter intervention had significantly correlated with depression in coronary heart disease. Conclusion Psychological intervention can reduce the ratio of depression in coronary heart disease after PCI.     

个体化心理干预在胃镜检查中的应用

Objective To investigate the role of individualized psychological intervention in gastroscopy.Methods 286 patients first underwent gastroscopy were randomly divided into the intervention and control groups,143 patients in each group. Individualized psychological intervention were provided for intervention group,and the patients of control group were just given routine nursing care. All the patients were measured by self rating anxiety scale (SAS) ,which were as measuring standards before and after intervention. At the same time,the blood pressure and heart rate were compared before and after intervention. Visual analogue scale (VAS) was observed to investigate the satisfaction of patients after operation. Results Compared with control group,anxiety rate and degree,blood pressure and heart rate in intervention group were lower( P ＜ 0. 05 ). The test of VAS revealed that the satisfaction of patients in intervention group was significantly higher than that in control group ( P ＜ 0. 05). Conclusion Individualized psychological intervention could improve negative emotion and relieve anxiety and affliction of patients underwent gastroscopy, and the satisfaction degree for gastroscopy was improved.     

冠心病患者冠脉支架植入前后Hs-CRP含量的变化及意义

Objective To detect the concentration of C-reactive protein in patients with coronary heart disease before and after percutaneous coronary intervention (PCI).Methods Forty patients with coronary heart disease that treated with PCI were enrolled.The serum concentration of C-reactive protein (CRP) was analyzed before and after the PCI.Results After PCI,the concentration of CRP were significantly increased compared with that before PCI[(13.91±3.61 ) mg/L versus ( 7.86±3.58 )mg/L,P＜0.01].Conclusion The concentrations of CRP in patients with coronary heart disease were significantly increased after PCI.The level of serum Hs-CRP may reflect inflammatory state of atherosclerosis plaque and it may be important to the prevention and treatment of complications after PCI.     

中青年男性冠心病患者PCI前后性生活质量的变化

Objective To investigate the effect of percutaneous coronary intervention (PCI) on the sexual quality of life among young and middle-aged male patients with coronary heart disease (CHD) by using Sexual Life Quality Questionnaire(SLQQ).Mothods 78 patients cured by PCI were kept in operation group and the drug therapy group contained 80 patients.The sexual quality of life one day before hospitalization and six months after discharge was surveyed with a retrospective questionnaire in both two groups.Results The sexual quality of life in 6 months after discharge in both groups was better than before hospitalization (P＜0.01);the operation group improved more obviously compared to the drug group (P＜0.01).Conclusions PCI can significantly improve the sexual quality of life among young and middle-aged male patients with CHD.     

左室射血分数降低的冠心病患者冠状动脉造影观察

Objective To explore coronary angiography detection in coronary heart disease patients with left ventricular ejection fraction decreasing. Methods The clinical data of 120 coronary heart disease patients were retrospectively analyzed. And the patients were divided into observation group and control group by decreasing of left ventricular ejection fraction. Results The incidence rate of more affection, anterior descending branch, convolution branch,left bole affection were higher than control group;The Gensini points of detection group were higher than control group( P ＜ 0. 05) ,and the difference was statistical significance. Conclusion Close attention on the changes of left ventricular ejection fraction in the clinic could provide reliable theory base.     

冠心病患者联用心理干预措施后的效果评价

目的 评价冠状动脉粥样硬化性心脏病(冠心病)患者在常规治疗和护理基础上联用心理干预措施后的效果.方法 将90例冠心病患者完全随机分为对照组(45例)和观察组(45例),对照组采用常规治疗和护理,观察组在此基础上联用心理干预措施.对2组患者的焦虑自评量表(SAS)评分、抑郁自评量表(SDS)评分、心功能及满意度评分进行比较.结果 治疗后观察组SAS评分为(22.6±7.5)分、SDS评分为(27.4±8.4)分,明显低于对照组的(42.3±9.4)分、(46.2±9.7)分,差异均有统计学意义(均P<0.01).治疗后观察组左心室射血分数为(49.6±3.5)%、左心室短轴缩短率为(27.4±1.9)%,明显高于对照组的(44.3±2.6)%、(21.2±2.1)%,差异均有统计学意义(均P<0.01).观察组总满意率为77.8%(35例),明显高于对照组的37.8%(17例)(X2=14.757,P<0.01).结论 冠心病患者治疗过程中联用心理干预措施无论是对心理健康状况的提高,还是对心功能和满意度的改善均具有重要意义,而且该方法简单易行、费用极低,无任何的不良反应,建议临床进一步推广.

Abstract：

Objective To evaluate the effects of the coronary heart disease patients treated with psychological intervention. Methods Ninety cases of the coronary heart diseas were randomly divided into observation group and control group. Control group was treated with conventional care and the observation group was treated with psychological intervention. Self-rating anxiety scal(SAS) , self-rating depression scale(SDS) , cardiac function and the Satisfaction rate were compared for these two groups. Results After treatment, SAS and SDS of observation group [(22.6 ±7.5) , (27.4 ± 8. 4) scores] were significantly lower than those of control group [(42.3 ±9.4) , (46. 2 ± 9.7)scores](P <0. 01). After treatment, left ventricular ejection fraction and fraction shortening of observation group[(49.6±3.5)% ,(27.4 ±1.9)%] were significantly higher than those of control group [(44. 3 ±2.6)% , (21.2±2.1)%](P<0.01). The overall satisfaction rate of observation group(77.8%, 35 cases)was significantly higher than that of control group ( 37. 8% , 17 cases) (X2 = 14. 7571, P < 0. 01). Conclusions Psychological interventions are important on the improvement of mental health, cardiac function and life satisfaction. It's simple, low cost, without any adverse reaction and worthy of further promotion in clinic.     

青年冠状动脉粥样硬化性心脏病伴抑郁症患者的临床特征及相关因素研究

目的 探讨青年冠状动脉粥样硬化性心脏病(冠心病)伴抑郁症患者的临床特点、相关因素及预后.方法 选择青年冠心病伴抑郁症患者76例为观察组,青年冠心病不伴抑郁症患者70例为对照组.对2组患者的临床特点、家庭及社会支持以及冠状动脉造影的结果进行分析对比并随访.结果 观察组患者严重睡眠障碍、焦虑激越、情绪低落、兴趣减退、自觉无用负罪感等症状的发生率与对照组比较差异有统计学意义.对照组的家庭和睦及社会支持率明显高于观察组(64.3%比26.3%,P＜0.01).动脉造影显示,观察组与对照组患者冠状动脉病变程度无明显差异.随访急性冠状动脉综合征(ACS)发生率、再住院率等指标观察组均明显高于对照组(15.8%比1.4%,36.8%比12.9%,P＜0.05).结论 青年冠心病伴抑郁症患者易产生严重睡眠障碍、焦虑激越、情绪低落、兴趣减退等症状;ACS发生率明显增高;临床要高度重视青年冠心病伴发抑郁症,积极识别及时治疗,有助青年冠心病患者预后改善,社会及家庭意义重大.

Abstract：

Objective To study the clinical characteristics of young coronary heart disease (CHD)patients suffering from depression. Methods The clinical data of 76 young CHD patients with depression (depression group) and 70 young CHD patients without depression (none-depression group)were enrolled. Clinical characteristics, family and social support, coronary angiography results of the two groups were followed up and compared.Results Severe sleep disorders, anxiety, agitation, depression in depression group were significantly higher than those in none-depression group ( P ＜ 0.05 ). Family harmony and social support in depression group were significantly lower than those in none-depression group ( P ＜ 0. 01 ). Angiography showed no significant difference between the 2 groups. Re-admission rate was significantly higher due to acute coronary syndrome (ACS) in depression group (P ＜0.05). Conclusions Young CHD patients with depression have high chance of suffering from sleep disorder,anxiety, agitation, depression, diminished interest and other complications such as ACS. Early identification and aggressive treatment can help improve the prognosis of young patients CHD with depression.     

肝癌介入治疗中疼痛患者应用心理干预的效果分析

Objective To investigate the psychology characteristics of liver cancer patients with pain and the effect of psychological intervention during the operation,Methods 216 eases of liver cancer were tested preoperative by SCL (SCL-90).Psychological intervention and analgesic drugs were orderly carried out when intraopsrative pain happened.And the pain degree of patients was tested by digital scale (NRS-10) before the psyehological intervention,after the psychological intervention and after the drug treatment.Statistical analysis was performed using the SPSS 11.0 software package.Results Each factor score of SCL-90 has significance statistical difference compare with domestic norm (P ＜0.05).The pain degree of patients in order decreased before the psychological intervention,after the psychological intervention and after the drug treatment,and there was statistical significant difference among them (P＜0.01).By psychological intervention,five eases were complete remission (2.31%),63 cases were effective remission (29.17%).All patients' pain was alleviated by drug therapy.The three SCL-90 scores:somatization,anxiety and fear of preoperative and that of pre-psyehological intervention was positively correlated (P＜0.05).Conclusion The psychological intervention as an effective means of pain control may alleviate liver cancer pain,and has a complementary role to drug therapy.     

阿托伐他汀干预对急性冠状动脉综合征患者PCI术后粘附分子水平的影响

Objective To explore the impact of different dose atorvastatin on the adhesion molecules level in the acute coronary syndrome (ACS) patients who had received percutaneous coronary intervention (PCI). Methods Eighty-eight ACS patients were divided into three groups, group A (normal treatment group), group B (normal treatment plus atorvastatin 10mg per day) and group C (normal treatment plus atorvastatin 80mg per day). The patients in group B received atorvastatin 10 mg per day orally before PCI and after PCI subsequently, and the patients in group C received atorvastatin 80 mg per day orally before PCI and after PCI subsequently for three days, then the dose of atorvastatin was decrease to 10 mg per day. The concentrations of soluble intercellular adhesionmolecule-1 (sICAM-1) and soluble vascular cell adhesion molecule-1 (sVCAM-1) were detected before PCI and at the 3rd, 7th 14th day after PCI. Results At the 7th day, the concentrations of sICAM-1 and sVCAM-1 in group C were significantly lower than those in group B, which showed sICAM-1 (68.35±23.80) μg/L vs (131.45±29.12) μg/L and sVCAM-1 (251. 65±36.61)μg/L vs (334.87±32.98) μg/L, respectively. Compared to group A, the adhesion molecule level in group B and group C were significantly decreased (P<0.05) and had no obviously affect on blood fat level. Conclusion The treatment of atorvastatin could significantly decrease the adhesion molecules' level after PCI, which may play an important role in lowing inflammation and coronary artery restenosis after PCI.     

冠心病患者经皮冠脉介入术后A型行为模式、焦虑及抑郁情绪心理矫正的研究

目的:探讨系统的心理矫正模式对冠心病患者经皮冠脉介入术(PCI)后A型行为模式(TABP)或兼合并有焦虑、抑郁情绪心理干预治疗的临床可行性。方法:将2005年1月—2007年5月入选210例患者,随机分为对照组(A)和心理干预组(B)进行对照研究,对心理干预组施行系统规范化心理矫正后,两组进行心理学评估。并同时随访观察6个月~2.5年,观察两组临床上的差异影响。结果:系统心理矫正前后2个月的心理评估分数,A组均明显低于B组(P<0.05和P<0.01),术后随访临床出现情况A组多于B组(P<0.05和P<0.01)。结论:心理矫正能有效地纠正A型行为和负性情绪,使反复就诊以及支架再介入例数明显降低。     

通心络胶囊用于冠心病介入术后患者疗效观察

目的观察通心络胶囊用于冠心病患者经皮冠状动脉介入治疗(PCI)术后的临床效果。方法选取2017年5月-2019年2月辽宁省丹东市人民医院心内科诊治的冠心病患者118例,均接受急诊PCI术治疗。采用随机数字表法分为观察组和对照组各59例。对照组给予常规术后治疗,观察组在对照组治疗的基础上给予通心络胶囊治疗。比较2组患者治疗前、治疗4周后炎性因子水平,随访6个月再狭窄、心血管事件发生率及不良反应发生率。结果治疗4周后,2组超敏C反应蛋白(hs-CRP)、白介素-6(IL-6)及肿瘤坏死因子-α(TNF-α)水平均低于治疗前(P<0.05),且观察组低于对照组(P<0.01)。随访6个月,观察组支架内再狭窄发生率及狭窄程度均低于对照组(P<0.05)。观察组心血管事件发生率为6.78%,低于对照组的20.34%(χ~2=4.628,P=0.031)。2组不良反应发生率比较差异无统计学意义(χ~2=0.069,P=0.793)。2组患者均未出现严重不良反应,未停药。结论通心络胶囊用于PCI术后患者效果好,有助于缓解炎性反应,预防心血管事件、支架内再狭窄发生,且用药安全性高,值得临床推广。     

心理护理干预对冠心病患者焦虑和抑郁情绪的影响分析

目的探讨心理护理干预对冠心病患者焦虑、抑郁情绪的影响。方法选择2011年4月至2012年5月收治的冠心病患者150例,随机分为两组,对照组72例给予常规护理,观察组78例在对照组基础上给予心理护理干预,并对两组患者焦虑、抑郁情绪进行评价。结果观察组和对照组焦虑自评量表(SAS)评分分别为(25.23±5.33)、(38.42±6.17)分,明显低于治疗前,且观察组患者明显低于对照组,差异有统计学意义(P<0.05);抑郁量表(SDS)评分观察组和对照组分别为(13.42±9.28)、(18.38±7.39)分,明显低于治疗前,且观察组患者明显低于对照组,差异有统计学意义(P<0.05)。结论对冠心病患者进行积极、全面的心理护理,可明显改善焦虑和抑郁情绪,对其康复有着积极作用。     

盐酸舍曲林治疗冠心病患者伴焦虑抑郁状态的疗效

目的 探讨盐酸舍曲林对冠心病患者焦虑、抑郁状态的影响.方法对179例冠心病伴焦虑、抑郁患者随机分为对照组87例和治疗组92例,给予冠心病常规治疗和心理治疗,治疗组同时给予盐酸舍曲林口服,25 mg起服,qd,早餐后服药,第3天加量至50 mg.疗程为8周.分别在治疗2周和治疗8周进行患者焦虑自评量表(SAS)、抑郁自评量表(SDS)、症状自评量表(SCL-90)评分和冠心病临床症状(心电图ST段改变级胸痛等)缓解情况比较.结果治疗8周后,盐酸舍曲林治疗组临床症状好转率(96.7%)较对照组(86.2%)高(P<0.05).治疗2周后和8周后治疗组和对照组SAS、SDS评分均较首次评定显著下降 (P<0.01);且治疗8周盐酸舍曲林治疗组较对照组SAS、SDS评分下降更为明显(P<0.05).SCL-90量表显示患者躯体化、抑郁和焦虑状态在治疗2周和8周均较入院时症状改善明显.结论盐酸舍曲林能明显改善冠心病患者焦虑、抑郁症状,并明显缓解冠心病患者急性期临床症状.     

心理干预对心绞痛型冠心病患者的影响分析

目的探讨分析心理干预对心绞痛型冠心病患者的影响。方法抽取本院2013年5月收治的100例心绞痛型冠心病患者,随机分为干预组和对照组,每组各50例。对照组进行心脏病的相关基础治疗,干预组在对照组基础上同时进行心理干预。比较两组的临床疗效及SDS、SAS评分。结果临床症状改善：干预组的总有效率为96％,高于对照组的74％（P〈0．05）;心电图检测结果：干预组的总有效率为90％,高于对照组的74％（P〈0．05）：两组干预前后的SDS、SAS评分差异有统计学意义,两组干预后的SDS、SAS评分差异有统计学意义（P〈0．05）。结论对伴发的抑郁、焦虑的心绞痛型冠心病患者进行相关心理干预,在改善抑郁、焦虑的同时．可明显提高对心血管疾病的整体疗效。     

冠心病患者冠脉支架植入前后Hs-CRP含量的变化及意义

目的 探讨冠心病患者冠脉支架植入前后血清C反应蛋白水平的变化及意义.方法 选择行冠脉支架植入术的冠心病患者40例,于支架植入术前及术后分别测定C反应蛋白(CRP)含量.比较PCI术前后CRP水平的变化.结果 冠脉支架植入术前血清CRP平均浓度为(7.86±3.58)mg/L,术后平均浓度为(13.91±3.61)mg/L,两者比较差异有显著性意义(P＜0.01).结论 C反应蛋白水平在冠心病患者冠脉支架植入术后较术前有显著升高,C反应蛋白水平可能对防治冠心病介入治疗术后并发症具有重要的意义.     

心理干预改善冠心病心绞痛患者抑郁症状的临床护理观察

目的探讨心理干预改善冠心病心绞痛患者抑郁状态的效果。方法根据Zung抑郁自评量表,将有抑郁状态的273例冠心病心绞痛患者随机分为观察组135例,对照组138例。两组均采用常规治疗和护理,观察组予心理干预。结果观察组心理干预后抑郁状态明显低于对照组,差异有统计学意义（均P〈0．05）。结论实施心理干预可改善冠心病心绞痛患者抑郁状态,且效果显著。     

浅谈非语言性支持对冠心病患者负性心理的干预

目的探讨非语言性支持对冠心病患者焦虑、抑郁的影响。方法将有不同程度焦虑、抑郁反应的160例冠心病患者随机分成对照组和干预组,对照组(n=80例)给予常规护理,干预组(n=80例)在此基础上强调非语言性沟通,进行心理干预。护理干预前及干预后三周对两组冠心病患者用SAS、SDS评分量表测评情绪状况,比较心理干预前后两组冠心病患者负性情绪指标的差异及护理干预效果。结果两组冠心病患者干预前SAS、SDS评分无显著性差异,无统计学意义(P>0.05),护理干预后干预组SAS、SDS评分明显低于对照组(P<0.01),干预组焦虑、抑郁程度比对照组减轻,两组差异具有统计学意义。结论非语言性支持能明显缓解冠心病患者焦虑和抑郁症状,对冠心病的治疗及改善疾病预后具有积极的意义。     

伊伐布雷定联合美托洛尔对冠心病患者PCI术后心功能及运动耐力的影响

目的:探究伊伐布雷定联合美托洛尔对冠心病患者经皮冠状动脉介入(PCI)术后心功能及运动耐力的影响。方法:选取某院2016年4月~2018年11月106例冠心病行PCI术患者,随机数字表法分为对照组与观察组各53例。对照组给予美托洛尔治疗,观察组给予伊伐布雷定、美托洛尔联合治疗,对比两组治疗前后6min步行试验(6MWT)距离、心功能指标[左室舒张末期内径(LVEDD)、左室射血分数(LVEF)]。结果:治疗后观察组6MWT距离长于对照组(P<0.05);治疗后观察组LVEDD低于对照组,LVEF高于对照组(P<0.05)。结论:伊伐布雷定联合美托洛尔应用于冠心病行PCI术患者,可提高运动耐力,改善心功能,安全性高。     

氟哌噻吨美利曲辛改善经皮冠状动脉介入术后病人的焦虑抑郁及预后

目的 评价氟哌噻吨美利曲辛对经皮冠状动脉介入治疗(PCI)病人的术后焦虑及抑郁改善及其预后效果.方法 选择成功接受PCI术的冠心病病人128例,双盲法随机分为观察组和对照组各64例,在内科常规治疗基础上,观察组加服氟哌噻吨美利曲辛片,每天2次,对照组给予同样剂型的安慰剂.在治疗开始前、治疗后1、2、4周分别进行状态焦虑量表和17项汉密尔顿抑郁量表评定,并比较治疗后两组心脏有关的临床症状和体征.结果 观察组治疗后的焦虑评分和抑郁评分均呈显明显下降趋势,治疗后1、2、4周的焦虑评分和抑郁评分与治疗前比较均差异有统计学意义(P<0.05),且观察组在治疗后同一时间的焦虑评分和抑郁评分均低于对照组,均差异有统计学意义(P<0.05).术后观察组的心绞痛、心肌梗死、室性心动过速、室性早搏的发生率均低于对照组,均差异有统计学意义(P<0.05).结论 氟哌噻吨美利曲辛应用于PCI术后的冠心病病人,能显著减轻其焦虑抑郁情绪,并能改善预后.