抑郁症对起搏器术后的影响及治疗策略

摘要

心脏起搏器早起主要用于治疗缓慢性心律失常，目前三腔起搏器及植入式心脏自动除颤复律起搏器在临床应用越来越广泛。由起搏器给患者带来的精神心理问题逐渐受到人们的关注。抑郁症是起搏器术后患者预后的重要危险因素，而起搏器术后患者又是抑郁症的高危人群。起搏器术后抑郁的发生是遗传、生物化学、细胞因子、心理、社会等多种因素共同作用的结果，药物治疗是目前的主要治疗方法，但其不良反应大、治愈率低、易复发，非药物的早期干预治疗显得尤为重要。起搏器植入术后抑郁的患者目前缺乏一系列合理、规范的诊疗模式，该文针对起搏器术后抑郁症患者的特点以及临床表现、发病机制、治疗等方面，探讨抑郁症对起搏器术后的影响。%A pacemaker is mainly used for treating tardy arrhythmia .Today three chamber pacemakers and automatic implantable cardiac pacemaker cardioversion defibrillation are becoming more and more widely applied in clinical.More attention is also being paid to cardiac pacemakers brought mental and psychological problems.Depression is an important risk factor for the prognosis of cardiac pacemaker implantation .And patients with cardiac pacemakers is are high-risk population of depression.Many factors such as genetic,bio-chemical,cytokine,psychological,social factors jointly lead to postoperative depression of cardiac pacemaker implantation.The current main treatment is medication,but it has disadvantages of great adverse reaction,low cure rate and easy relapse,thereforenon-drug therapy is very important.However,so far there is no standard-ized reasonable diagnosis and treatment model,and here is to make a review of the disease features,clinical manifestations,pathogenesis and treatment of postoperative depression of cardiac pacemaker implantation,and discuss the influence of depression on the prognosis of the operation .