心理干预对心力衰竭患者的影响

目的：探讨慢性心力衰竭（心衰）患者的心理障碍及心理和药物的抗抑郁干预效果。方法：采用抑郁状态问卷（DSI）、症状自评量表（SCL-90）对117例心衰患者进行问卷调查，按DSI评定，58例伴有抑郁者被随机分被为干预组（30例）及对照组（28例），干预组在进行常规治疗的同时给予心理及药物抗抑郁干预，对照组接受常规抗心衰治疗，比较两组疗效。结果：按SCL-90调查，伴有抑郁的心衰患者的躯体化、抑郁、焦虑、总分、阳性均分、恐怖、偏执等项较常模显著增加（P〈0．05～〈0．01）。与对照组比较，干预组干预后抑郁评分、症状、住院时间、出院后再次就诊次数显著减少（P〈0．05～〈0．01）。结论：心理因素在心衰的发生、发展及预后中不可忽视，有效的心理及药物抗抑郁治疗能促进患者康复。

Psychological assessment and intervention in patients with heart failure

Objective： To study the psychologic obstacle in inpatients with congestive heart failure （CHF） and the effect of psychology/drug intervention on the patients with psychologic obstacle. Methods： A total of 117 CHF inpatients were inventoried by depression status inventory （DSI） and symptom checklist （SCL） -90. According to DSI score, 58 depression patients were randomly divided into intervention group （30 cases） and control group （28 cases）, then psychological/drug intervention and relaxation training were performed in the intervention group, while routine therapy for CHF were performed in control group. The effect between two groups was compared. Results： In the inventory by SCL--90, the scores of somatizations, depression, anxiety, total score, positive average score, phobias and paranoid ideation were higher than those of internal norm in intervention group. Compared with control group, after psychological/drug intervention the DSI score, clinic symptom, day stay in hospital and the number of times returning visit to out--patient clinic for heart failure significantly decreased （P〈0.05-〈0.01）. Conclusion： A series of psychologic obstacle can not be ignored in patients with CHF; anti--depress therapy by psychological/drug intervention is helpful to promote recovery of patients.