比较两种测量方法对心脏外科手术术前患者焦虑抑郁的评估结果

摘要

目的：对比脑指标与9项病例健康问卷（PHQ-9）和7项广泛性焦虑（GAD-7）自评量表对心脏外科手术术前患者焦虑抑郁的评估结果。方法随机选取阜外医院心脏外科病房2015年7月～10月行心脏外科手术患者146例，男性99例，女性47例，年龄20～78岁。应用PHQ-9和GAD-7量表评估患者术前的抑郁、焦虑状态。同时，使用HXD_I多功能组合式监护仪测量脑指标（内专注+外专注），时长6 min。结果根据主观量表PHQ-9、GAD-7总分进行分组，共分两组：焦虑抑郁组（61例）：PHQ-9≥5分或GAD-7≥5分；无焦虑抑郁组（85例）：PHQ-9＜5分且GAD-7＜5分。焦虑抑郁组脑指标内专注+外专注为（54.82±27.50），无焦虑抑郁组为（37.12±17.81），两组比较差异有统计学意义（P＜0.05）。焦虑抑郁组脑指标内专注+外专注的中位数是51，无焦虑抑郁组中位数是34。用量表进行焦虑抑郁筛查，有焦虑抑郁61例（41.78%），无焦虑抑郁85例（58.22%）；用脑指标内专注+外专注筛查入选者焦虑抑郁的结果：有焦虑抑郁70例（47.95%），无焦虑抑郁76例（52.05%），总符合率为66.44%。两种方法的诊断结果进行Spearman相关分析，相关系数为0.266，差异有统计学意义（P=0.001）。Kappa值为0.324（P＜0.001），一致性较好。结论脑指标（内专注+外专注）与量表评估心脏外科手术术前患者焦虑抑郁结果的一致性较高，且客观，为患者焦虑抑郁的评估提供新选择。%Objective To compare the review results of anxiety and depression between 9-item patient health questionnaire (PHQ-9) and 7-item self-rating scale of generalized anxiety disorder (GAD-7) in patients before cardiac surgery.Methods The patients undergone cardiac surgeries (n=146, male 99, female 47 and aged from 20 to 78) were randomly chosen from the ward of Department of Cardiac Surgery in Fuwai Hospital from Jul. 2015 to Oct. 2015. PHQ-9 and GAD-7 were used to review the status of anxiety and depression in the patients before surgery. Meanwhile, brain indexes (internal concentration+external concentration) were detected for 6 min by using HXD_I multi-function combined monitor.Results The patients were divided, according to the total scores of PHQ-9 and GAD-7, into anxiety-depression group (n=61, PHQ-9≥5 or GAD-7≥5) and non-anxiety-depression group (n=85, PHQ-9<5 and GAD-7<5). The brain indexes (internal concentration+external concentration) were (54.82±27.50) in anxiety-depression group and (37.12±17.81) in non-anxiety-depression group (P<0.05). The median of internal concentration+external concentration was 51 in anxiety-depression group and 34 in non-anxiety-depression group. After screening with scales, there were 61 patients (41.78%) with anxiety and depression, and 85 (58.22%) without anxiety and depression. The results of screening by using brain indexes (internal concentration+external concentration) showed that there were 70 patients (47.95%) with anxiety and depression, and 76 (52.05%) without anxiety and depression, and the total accordance rate was 66.44%. The diagnostic results from 2 methods were given Spearman correlation analysis, and outcomes showed that correlation coefficient was 0.266 (P=0.001) and Kappa was 0.324 (P<0.001) with higher consistency. Conclusion The consistency is higher between the results from brain indexes (internal concentration+external concentration) and scales for reviewing status of anxiety and depression in patients before cardiac surgery, which provides a new choice for reviewing anxiety and depression.