心理干预在原发性闭角型青光眼治疗中的临床研究

目的探讨心理干预对原发性闭角型青光眼（PACG）患者焦虑、抑郁及眼内压的影响,探索将心理干预应用于PACG辅助治疗的具体方法。方法将48例PACG患者随机分为两组,除干预组给予心理干预及放松治疗外,其他术前准备、手术方式均相同。分别于入院时、术前1 d晚上、术后1 d和出院时检测汉密尔顿焦虑量表及抑郁量表评分,隔日测量眼内压,t检验分析组内及组间差异。结果两组入院时焦虑、抑郁评分及眼内压比较差异无显著性,在术前1 d,术后1 d及出院前干预组和对照组的焦虑值相比分别是24.85±4.22 vs 36.82±3.76（P〈0.01）,24.23±4.73 vs 37.82±3.23（P〈0.01）,22.27±4.16 vs 25.68±3.64（P〈0.01）,干预组明显低于对照组,差异有显著性;抑郁值相比分别是27.58±3.73 vs 29.86±4.35（P=0.02）,27.62±4.59 vs 30.45±4.77（P=0.02）,23.62±3.56 vs 26.5±3.6（P〈0.01）,干预组明显低于对照组,差异有显著性;干预组的眼内压仅在术前1d和出院前明显低于对照组,分别是31.27±7.30 vs 34.95±6.00（P=0.032）,18.23±2.32 vs 19.68±2.12（P=0.015）,差异有显著性。结论心理干预有助于缓解术前和术后的焦虑及抑郁情绪,维持术后平稳的眼内压。

Clinical studies on effects of psychological intervention in the treatment of primary angle-clossure glaucoma

Objective To explore the effects of psychological intervention on anxiety,depression and intraocular pressure in patients with primary angle closure glaucoma（ PACG）,and to explore the exact way of psychological intervention on PACG. Methods Fort-eight patients were divided into two groups randomly. There are no difference in the general situation,medication,surgical Methods,while the intervention group was given psychological intervention. The value of Hamilton Anxiety Scale and Depression Scale were detected respectively at the time of admission,the night before surgery,one day after surgery and discharge. Intraocular pressure were measured every other day after surgery. Data are compared using t test within groups as well as between groups. Results There are no difference between two groups at the time of admission. And the value of Hamilton Anxiety Scale and Depression Scale are significantly lower in intervention group than in control group at all time points（ all P〈 0. 05）. Intraocular Pressure is significantly lower in intervention group than in control group at the night before surgery and the day of discharge（ P = 0. 032,P = 0. 015,respectively）. Conclusion Psychological intervention is helpful in relieving anxiety and depression and maintaining stable postoperative intraocular pressure before and after surgery.