心理行为干预对急性心肌梗死患者心理健康生活质量及临床疗效的影响

The influence of psychological intervention on mental health,life quality and clinic effect of acute myocardial infarction patients

目的探讨心理行为干预对急性心肌梗死(AMI)患者预后的影响。方法将120名AMI患者随机分为对照组及试验组(每组60例)进行对照研究。试验组在临床治疗的基础上进行心理行为干预治疗,对照组只进行常规临床治疗,2组患者于干预前、干预后1个月末及6个月未分别用症状自评量表(SCL-90),焦虑自评量表(SAS),抑郁自评量表(SDS)对入组患者进行问卷调查；于治疗前及6个月后用生活质量综合评定问卷(GQOLI-74)评定患者治疗前后的生活质量。结果干预后试验组SAS[(45．45±10．26)分]、SDS[(52．85±10．14)分]标准分均明显低于对照组(P＜0．05)。试验组SCL-90在躯体化、人际关系、抑郁、焦虑、恐怖5因子上得分明显低于单纯药物治疗的对照组(P＜0．05),而试验组在生活质量总分、心理健康维度、躯体健康维度得分明显高于对照组(P＜0．05)。AMI患者住院1个月后接受康复心理治疗的试验组总的评价比对照组好；心绞痛发生率明显低于对照组(11例vs 24例)。结论心理行为干预能明显提高AMI患者的心理健康水平,改善AMI患者的生活质量,提高其临床治疗效果。

Objective To explore the influence of psychological intervention on mental health,life quality and clinic effect of acute myocardial infarction（AMI） patients. Methods 120 patients with AMI were divided into study group （60 cases） and regular treatment group （60 cases） by simple randomization. The study group received psychological intervention on the basement of clinical treatment. At baseline and one months after intervention and six months the mentation of the both group patients were measured with SCL-90, SAS , and SDS. The quality of life of the patients were evaluated with GQOLI-74 at baseline and six months in discharged from hospital and both groups were compared at the same term and period was six month. Results Psychological intervention with acute myocardial infarction can improved of the anxietive and the depressive of the patients with acute myocardial infarction. The SAS, SDS scores of study group are lower than regular treatment group （ P 〈 0.05 ）. The SCL- 90 factorial scores of the study group were significantly lower on somatization, interpersonal sensitivity, depression, anxiety, phobia somatization than the regular treatment group （ P 〈 0.05 ）, and the study group scored higher on total score of GQOLI, physical health, mental health dimensions than the regular treatment group after psychological intervention（ P 〈 0.05 ）. After one months, the patient＇s total assessment is nicer in psychotherapy group than comparative group. The appearing rate of the bad thing of the heart was lower than regular treatment group. Conclusion Psychological intervention with acute myocardial infarction can improved the mood and the quality of life of the patients, and the therapic effect of treatment and the prognosis of patients with AMI is good.