急性心肌梗死患者伴抑郁状态的治疗与心理护理

目的了解因急性心肌梗死住院的患者是否存在抑郁症状,同时探讨抗抑郁治疗和心理干预对急性心肌梗死患者预后的影响。方法随机选取因急性心肌梗死住院的患者118例,采用贝克抑郁调查表对每位患者进行调查,将评分>10的患者43例随机分为对照组(21例)和治疗组(22例);对照组进行常规治疗与护理;治疗组在此基础上应用抗抑郁药物黛立新,并进行心理干预护理。1个月后再次进行问卷和病情转归调查。结果入选的急性心肌梗死患者中有28%有轻~中度抑郁症状。抗抑郁治疗1个月后,再次心绞痛或心肌梗死的发生率显著降低(P<0.05)。再次心肌梗死人数对照组比治疗组多,但由于例数少,无明显的统计学意义。结论抑郁症状在因急性心肌梗死而住院的患者中常见,抗抑郁治疗和心理护理干预能降低急性心肌梗死1个月内再次心血管事件和再住院的发生率。

Treatment and mental nursing of patients with acute myocardial infarction having depression

Objective To explore whether there were the symptoms of depression among the patients following the hospital admission because of the disease of acute myocardial infarction, and to investigate the effect of anti-depression treatment and mental nursing on these patients.Methods 118 patients who had been documented as having acute myocardial infarction were recruited for the study. The study was performed by trained nurses who worked as the interviewers of the patients. The nurses collected the information from the medical records and asked the study subjects to complete the Beck Depression Inventory questionnaire during their stay in hospital. Secondly, 43 patients who had a score of 10 or more were randomly divided into the control group (routine treatment and nursing, 21 individuals) and the treatment group (antidepressant drug, deanxit, and mental nursing were used on the base of routine treatment and nursing, 22 individuals). And a mailed questionnaire was used one month later. Results Of the 118 study subjects, 43(28%) had a score of 10 or more, indicating at least a mild depression. And the rates of recurrent ischemia or infarction were significantly decreased after treatment of antidepressant drug and mental nursing within 30 days from the first admission to hospital (P<0.05). Conclusions Depressive symptoms are common in the patients with acute myocardial infarction. The treatment with antidepressant drug and the mental nursing can decrease acute myocardial infarction, the risk of recurrent ischemia or infarction and the incidence rate of re-admission to hospital one month later.