目的 研究冠状动脉粥样硬化性心脏病(冠心病)患者介入治疗前后焦虑抑郁障碍情况以及心理干预的效果.方法 采用Zung抑郁自评量表(SDS)对105例拟接受冠状动脉介入治疗的冠心病患者进行焦虑抑郁障碍调查评分.将105例患者完全随机分为干预组57例和对照组48例,干预组在手术前1～2 d和手术后7～10 d、3、6、12、24个月进行焦虑抑郁评定及心理干预,对照组常规治疗并于同时间进行焦虑抑郁评定.同时将影响因素与SDS评分之间进行多因素相关分析.结果 术前2组患者抑郁发生率、SDS评分差异无统计学意义.心理干预后干预组的抑郁障碍较对照组有明显改善[SDS评分:(37±4)分比(46±6)分,P＜0.01],对照组手术前后抑郁发生率无明显变化,而干预组术后抑郁发生率明显低于对照组,差异有统计学意义[15.8%(9例)比35.4%(17例),P＜0.05].多因素分析显示:教育程度、近期负性生活事件、家庭收入、住院时间、导管介入治疗后遗症与冠心病抑郁之间存在明显相关性(P＜0.01).结论 积极的手术前后心理干预可以有效减轻抑郁障碍情况.%Objective To discuss the effect of psychological intervention of depression in coronary heart disease after percutaneous coronary intervention (PCI). Methods The depression of 105 cases of coronary heart disease after PCI treatment was investigated. One hundred and five patients were randomly divided into intervention group and control group. The patientsin intervention group were treated with psychological intervention before and after PCI. The patients in control group were treated with normal treatment. Results There was not significant difference of incidence of depression an self-rating depression scale score between two groups. The depression in intervention group was less severe than that in control group ( P ＜ 0.01 ). Multivariate analysis showed: education level, the recent negative life events, household income, length of stay and sequelae of catheter intervention had significantly correlated with depression in coronary heart disease. Conclusion Psychological intervention can reduce the ratio of depression in coronary heart disease after PCI.
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