心脏起搏器置入患者心理影响因素调查分析

Investigation and analysis on the psychosocial influence factors of patients with pacemaker

目的调查接受人工心脏起搏器置入患者心理因素并探讨心理干预对其的影响,为循证医学提供临床依据。方法应用《症状自评量表(SCL-90)》、《抑郁自评量表(SDS)》、《焦虑自评量表(SAS)》评定,并对永久人工心脏起搏器置入患者术前及安装永久人工心脏起搏器后随访患者的心理状态进行调查。通过Holter、超声心动图检查及电话监测证实在不同起搏方式下存在起搏器综合征的某些精神症状,分析上述评分与患起搏器综合征的相关性。结果共收回有效调查答卷82份,起搏器综合征患者术前及术后SCL-90、SDS、SAS评分均显著高于对照组(P<0．05);有起搏器综合征的某些精神症状与SCL-90、SDS、SAS评分高度相关(r=0．95,P<0．01)。结论接受人工心脏起搏器置入患者均具有不同程度的心理问题,提示心理因素与起搏器综合征的发病有一定关系,在综合治疗的基础上,应进行相应的心理干预。

Objective To investigate the psychosocial factors of patients with pacemaker, so as to explore the effects of psychological intervention for the patients,thus providing clinical basis.Methods Using SCL-90,SDS and SAS the relevant psychosocial factors of the 82 patients were investigated and assessed before and after pacemaker therapy. Then the patients were subjected to mental intervention （as observed group）, also, another 80 patients were selected as controlled group. Results The rating scores of observed group in SCL-90,SDS and SAS were significantly higher than that of eontrolled group （P〈 0.05） before and after the mental intervention; though two group had all suffered from anxiety and depression seriously before the operation, but after the mental intervention the observed group was greatly related with above-mentioned rating scores （r=0.95,P〈0.01）.Condusion The patients, who received pacemaker, all have psychological disorders at certain extents. This results suggests that psychological factors is related with development of pacemaker syndrome, thus on the basis of combined treatment responsible psychological intervention should be taken.