腹部大器官移植受者术后早期心理精神分析及对策

目的分析腹部大器官移植受者术后早期心理状况,分析其原因并提出干预措施。方法选取54例接受腹部大器官移植的受者,除临床观察评估外还采用一般健康问卷、贝克焦虑量表、贝克抑郁量表进行测量,根据临床观察和问卷评估结果将患者分为正常组和精神异常组,比较两组患者20项客观指标的差异。结果54例受者中24例(44%)出现了心理或精神状态异常,主要表现为:焦虑/失眠15例,抑郁6例,幻听1例、欣快感2例。两组术前等待时间、不同免疫抑制剂方案、腹部置引流管时间以及患者有无肝炎背景4项指标均存在显著性差异(P<0.05)。结论腹部大器官移植术后早期发生精神心理异常是多种因素作用的结果,应积极做好术前准备,合理使用免疫抑制剂,消除负性心理以及预防并发症等,减少患者移植术后早期精神异常的发生。

Analysis of the Mental Status of Patients in the Early Stage after Abdominal Organ Transplantation and Measure

Objective To analyze the mental and psychological status in the early stage after abdominal organ transplantation,find the cause and put forward intervention measures.Methods Fifty-four patients received abdominal organ transplantation in their hospital form September,2000 to December,2004 were evaluated by questionnaires including General Health Quality(GHQ-12),Beck Anxiety Inventory(BAI) and Beck Depression Inventory(BDI),in addition to clinical observation and evaluation.They were divided into two groups according to the results.Results Twenty-four(44%) patients developed mental or psychological disorder after transplantation,which including 15 cases of anxiety/insomnia,6 cases of depression,1 case of acousma and 2 cases of euphoria.There were significant differences in four indexes including preoperative waiting time,different immune suppressive plans,time of abdominal organ catheter and having or having not hepatitis(P<0.05).Conclusion The mental and psychological disorder in the early stage after abdominal organ transplantation is the result of multi-factors,which is supposed to be prevented by positive preparation before operation,rational use of immunosuppressive agents,eliminating negative emotion and prevention of complications.