心理护理对急性冠状动脉综合征伴抑郁患者康复疗效的影响

Psychological nursing on the rehabilitation effect of patients with acute coronary syndrome accompanied by depression

目的探讨心理护理对急性冠状动脉综合征（ACS）合并抑郁患者康复疗效的作用。方法将126例ACS患者随机分为心理护理组64例及对照组62例。对照组采用心血管常规康复治疗；心理护理组在常规心血管康复治疗的同时进行规范的、有针对性的心理护理；2组患者治疗前后分别予以Zung抑郁自评量表（SDS）及汉密尔顿抑郁量表（HAMD）进行评估，并在常规心血管康复治疗前后对2组患者的心电图、临床症状、心血管并发症等进行观察比较。结果常规心血管康复治疗前2组患者的SDS、HAMD评分比较差异均无统计学意义（P〉0．05），但康复治疗5周后2组患者的SDS、HAMD评分比较差异均有统计学意义（P〈0．01）；而且心理护理组较对照组，在心电图缺血性改变的阳性率、心绞痛的发作频率、心血管并发症的发生率及死亡率等方面均有显著的降低（尸〈0．05）。结论心理护理不但可以明显改善ACS合并抑郁患者的抑郁症状，而且能够显著减轻ACS患者的临床症状，降低心血管事件再发的概率。

Objective To study the psychological nursing on the rehabilitation effect of patients with acute coronary syndrome （ACS） accompanied by depression. Methods 126 ACS patients were divided into the nursing group（64 cases） and the control group（62 cases） randomly.The control group adopted routine rehabilitative nursing measurs.While the nursing group received canonical and selective psychological nursing.The Zung Serf-rating Depression Scale（SDS） and hamilton depression scale（HAMD） were used to evaluate the their psychological status. The electrocardiogram,clinical symptom and cardiovascular complications were observed and compared. Results The SDS and HAMD scores were different between the nursing group and the control group（P 〈 0.01 ） 5 weeks after rehabilitative nursing but not before it.The ischemic changes of electrocardiogram,incidence frequency of angina pectoris and cardiovascular complications were significantly decreased in the nursing group compared with the control group（P 〈 0.05）. Conclusion Psychological nursing could not only alleviate the depression of patients with ACS but also could improve the clinical symptoms of these patients and decrease the incidence frequency of cardiovascular events.