心律失常患者射频消融术术前心理状况及心理干预的观察

Investigation on the Psychological State of Patients in Preoperative Period of Radiofrequency Catheter Ablation and on the Effects of Psychotherapy

目的 :了解射频消融术前患者的心理健康状况及心理干预的作用。方法 :选择 138例择期行射频消融术患者 ,随机分为两组 ,一组为治疗组 96例 ,另一组为对照组 4 2例。治疗组采用症状自评量表 (SCL - 90 )调查 96例射频消融术前患者 ,并用焦虑自评量表 (SAS)、抑郁自评量表 (SDS)分别评价 96例射频消融患者心理干预前后焦虑、抑郁、恐惧的得分变化及其与 4 2例对照组的差别。结果 :SCL - 90调查显示 :96例射频消融术前患者主要表现的心理问题为焦虑 (4 8例 )、抑郁 (38例 )、恐惧 (36例 )、躯体化 (2 8例 ) ,其得分均高于国内常模 (分别为 2 10± 0 6 0vs 1 39± 0 4 3、2 0 3± 0 6 3vs 1 5 0±0 5 9、2 2 1± 0 6 0vs 1 2 3± 0 4 1、2 18± 0 5 3vs1 37± 0 4 8,P均 <0 0 1) ;人际关系 (2 5例 )为 2 10± 0 4 8vs 1 6 5± 0 5 1,P<0 0 5。心理干预后患者焦虑、抑郁、恐惧得分明显下降 ,与干预前相比有统计学显著性差异 (分别为 4 3 2 4± 7 2 8vs4 8 6 8± 9 35、4 0 12± 6 0 8vs 4 6 4 4± 7 6 5、4 1 30± 6 2 5vs 4 5 6 5± 8 4 5 ,P均 <0 0 1) ,而对照组两次评分比较无统计学显著性差异。结论 :射频消融术患者存在焦虑、抑郁、恐惧、躯体化、人际关系等明显心理问题 ,有效?

Objective:To investigate the psychological state and the effects of psychotherapy in radiofrequecy catheter ablation patients.Methods:One hundred thirty eight patients were divided into two groups at random , 96 patients received psychotherapy, and the other served as controls. Symptom check-list 90(SCL-90)was used for evaluating the patients' psychological state . SAS(self-Rating Anxiety Scale )and SDS (self-Rating Depression Scale) were used for rating the patients scores of anxiety depression and phobia before and after psychotherapy . The scores of anxiety and depression phobia were respectively compared before and after psychotherapy; the controls' scores were taken at same time as psychotherapy group. Results:The SCL-90 showed that the 96 radiofrequency catheter ablation patients had serious psychological problems in five aspects: anxiety (44 patients ),depression (28 patients ), phobic anxiety (36 patients), somatization (38 patients), interpersonal sensitivity (25 patients). The score of each factor was respectively higher than thaf of the normal as following : 2.10±0.60 vs 1.39±0.43,2.03±0.63 vs 1.50±0.59 ,2.21±0.60 vs 1.23±0.41 ,2.18±0.53 vs 1.37±0.48, 2.10±0.48 vs 1.65±0.51,P<0.01 or 0.05. The scores of the anxiety depression and phobia decreased markedly after psychotherapy (43.24±7.28 vs 48.68±9.35,40.12±6.08 vs 46.44±7.65,41.30±6.25 vs 45.65±8.45,all P<0.01) . There were no statistically obvious changes in the controls before the radiofrequency catheter ablation procedure. Conclusion: Radiofrequency catheter ablation patients have obvious psychological problems in anxiety ,depression, phobic anxiety, somatization and interpersonal sensitivity. Effective psychotherapy can relieve the patients' anxious and depressive emotions.