心理干预对颈动脉狭窄行支架植入治疗患者心理状态的影响研究

摘要

目的：探讨心理干预对颈动脉狭窄行支架植入治疗患者心理障碍的疗效及安全性。方法选择拟进行数字减影血管造影（DSA）+颈动脉血管内支架成形术（CAS）的患者，利用前瞻性研究的处理方法，按照随机双盲的分配原则，将研究对象随机分为实验组和对照组，实验组110例，其中男78例，女32例，年龄49～72岁，平均年龄（61.5±11.7）岁；对照组50例，其中男35例，女15例，年龄46～74岁，平均年龄（62.1±10.8）岁。术前对所有受试者进行一般治疗和护理；采用SAS、SDS、SCL-90三个心理量表对其心理状态分别在术前及术后2周进行评分。并对实验组进行适当的心理干预措施；2周后，再次评价，对数据进行统计分析。结果（1）所有受试者在性别、发病年龄、发病持续时间及受教育情况方面比较，差异无统计学意义（P＞0.05）；（2）术前，两组SAS、SDS和SCL-90评分均升高，差异无统计学意义（P＞0.05）；（3）术后2周，与术前相比，实验组SDS、SAS和SCL-90总分明显下降（P＜0.01）；而对照组SAS及SDS有所升高，只有SAS评分升高较显著，得出的数据差异显示有统计学意义， SCL-90评分较前升高不明显，数据对比差异无统计学意义（P＞0.05）；（4）术后，两组SAS、SDS、SCL-90评分比较，差异均有统计学意义（P＜0.01），实验组的3个量表总分均较对照组下降。结论心理干预治疗可改善接受介入治疗的颈动脉狭窄患者的心理状态，提高治疗效果，改善预后。%Objective To explore the effcacy and security of psychological intervention on the mental state in patients with cartid stenosis stenting treatment.Methods We put the patients with DSA and CAS together, and classiifed them randomly into two groups, the experimental group had 110 cases, with 78 male cases and 32 female cases, the age are from 49 to 72, the average age was (61.5±11.7). The control group has 50 cases, with 35 male cases, and 15 female cases, the average age was (62.1±10.8). We evaluated the psychological status of the patients using SAS, SDS, SCL-90 psychololgical scale before the operation and 2 weeks after the operation respectively. The scales were SAS, SDS, SCL-90.and all the subjects got general preoperative treatment and care, The difference was that the experimental group got psychological intervention designed in advance before the operation, and two weeks later, we evaluated the two groups of psychological state again, and analyzed the data with SPSS 13.0 statistics software.Results (1) All the cases showed no statistically significant difference on the pathogenesis of gender, age, duration of disease and educated level (P>0.05). (2) Several mental status got a higher score in preoperative scoring results whenever no statistically signiifcant difference was found among them (P>0.05). (3)For the experimental group, SDS,SAS, SCL-90 decreased dramatically compared with the preoperative (P<0.01), in terms of the control group, compared with preoperative, SAS and SDS was increased a little, only SAS have statistically significant difference ,while SCL-90 was higher but showed no statistically difference. (4) After surgery, the scores of two groups showed signiifcant difference (P<0.01), moreover, the experimental group got lower scores compared with control group.Conclusion Preoperative psychological intervention can help patients to improve the psychological state, treatment effect and prognosis.