冠状动脉旁路移植围术期生活质量状况及相关心理影响因素

目的调查该科行患者冠状动脉旁路移植术(CABG)围手术期的生活质量状况以及探讨术后抑郁焦虑等心理因素对术后生活质量的影响。方法以该科连续行择期CABG术的61例患者为研究对象,分别在术前1周内和术后出院前1天使用ZUNG氏抑郁自评量表、焦虑自评量表和生活质量评定量表SF-36进行抑郁焦虑状态和生活质量状况评定。根据患者术后是否存在抑郁焦虑状态把患者分为抑郁焦虑组和非抑郁焦虑组,对比分析两组间术前、术后的生活质量状况。结果手术前共有20例(32.8%)阳性患者,其中10例患者存在抑郁状态,7例患者同时存在抑郁和焦虑状态,3例存在焦虑状态。手术后共有29例(47.5%)阳性患者,其中15例患者存在抑郁状态,12例患者同时存在抑郁和焦虑状态,2例存在焦虑状态。术后抑郁标准分显著高于术前抑郁标准分(P=0.022),焦虑标准分术前、术后虽然差异没有显著性,但术后焦虑标准分平均值高于术前。比较术后生活质量评分发现抑郁焦虑组社会功能和精神健康分项评分显著低于非抑郁焦虑组(P=0.001,P=0.036),其他分项和总评分差别没有显著性,但平均值均低于非抑郁焦虑抑郁组。结论CABG术后存在抑郁焦虑状态的患者生活质量评分中社会功能和精神健康分项评分显著降低不存在抑郁焦虑状态的患者,需要引起重视以提高患者术后的生活质量。

Investigation of peri-operative quality of life and the effect of depression and anxiety symptoms after coronary artery bypass grafting

[Objective] To investigate the peri-operative quality of life (QOL) and discuss the effect on QOL of depression and anxiety symptoms after coronary artery bypass grafting (CABG). [Methods] We followed 73 patients who underwent scheduled consecutive CABG We interviewed patients to assess depression and anxiety symptoms using self-rating depression scale( SDS) and self-rating anxiety scale(SAS)and QOL using SF-36 scale in the week before operation and in the day before leaving hospital. The patients were divided into depression group and anxiety group and no depression and anxiety group according to with or without depression and anxiety. The QOL were compared between the two groups. [Results] 20 patients(32.8%) had depression and/or anxiety symptoms before CABG, including 10 patients who had depression symptoms, 7 patients who had depression and anxiety symptoms and 3 patients who had anxiety symptoms. 29 patients (47.5%) had depression and/or anxiety symptoms after CABG, including 15 patients who had depression symptoms, 12 patients who had depression and anxiety symptoms and 2 patients who had anxiety symptoms. The SDS score after CABG was significantly higher than score pre-surgery (P =0.022). There is no difference in SAS score, but the average of SAS score after surgery was higher than pre-surgery. The scores of social functioning and mental health of QOL in the group with depression and anxiety are significantly lower than the group without depression and anxiety (P =0.001, P =0.036). The other scores OF QOL are not significantly different, but the average scores in the group with depression and anxiety are lower than the group without depression and anxiety. [Conclusion] A part of the QOL score in the group with depression and anxiety are significantly lower than the group without depression and anxiety after CABG. The quesion should be paid much more attention to improving prognosis of the patients.