双心室再同步化起搏患者焦虑抑郁情绪测评及心理干预研究

Emotion of Depression and Anxiety in Patients with CRT and the Effect of Psychological Intervention

目的:探讨双心室同步化起搏(Biventricular pacing,CRT)患者手术前后焦虑抑郁情绪以及心理干预对其的影响。方法:30例行双心室同步化起搏患者术前及术后一天均进行焦虑抑郁情绪测评[医院焦虑抑郁情绪量表(HAD,包括焦虑(A)和抑郁(D)部分)和Beck抑郁量表(BDI量表)],并将患者随机分为心理干预组和非心理干预组各15例,一周后再次评定焦虑抑郁情绪,比较两组统计学差异。结果:所有双心室同步起搏患者术后一天焦虑抑郁情绪对术前[HAD(A):(6.82±3.96)vs(9.95±4.76);HAD(D):(5.53±3.37)vs(9.12±6.04);BDI:(7.41±5.01)vs(12.76±8.04)]明显改善(均P<0.05)。术后一周非心理干预组焦虑抑郁差值与心理干预组比较有显著统计学意义,且心理干预组术后焦虑抑郁情绪较术前比较亦有明显改善[HAD(A):(4.59±3.54)vs(9.95±4.76);HAD(D):(4.59±2.83)vs(9.12±6.04);BDI:(5.41±3.92)vs(12.76±8.04)],P<0.05,差别有显著统计学意义。结论:双心室同步化起搏能改善心肌病患者焦虑抑郁情绪,术后早期心理干预治疗能更加显著改善患者焦虑和抑郁情绪,为该类患者术后提高生活质量,减轻医疗负担,具有显著临床意义。

Objective The purpose of this study is to observe the emotion changes in the patients receiving biventricular pacing （CRT） and the effect of psychological intervention. Methods 30 patients：receiving CRT were conducted psychological evaluation [HAD（A） ,HAD（D） and BDI] before operation and the day after operation, and then these patients were divided randomly into two groups： psychological intervention （15 cases） and non-psychological intervention （15 cases）. One week after operation, psychological evaluation was conducted again in all these patients, and their emotion score changes were compared. Results The degree of anxiety and depression was significantly improved（ P 〈 0.05） one day after CRT operation[ HAD（A） ： （6.82 ± 3.96） vs （9.95± 4.76） ; HAD （ D ） ： （5.53± 3.37） vs （ 9.12 ± 6.04 ） ; BDI： （ 7.41 ± 5.01 ） vs （ 12.76 ± 8.04 ） ]. And the level of emotion changes was significant improved （P 〈 0.01） after a week of psychological intervention than before opertation[ HAD（A）：（4.59 ±3.54） vs （9.95± 4.76） ; HAD（D） ： （4.59± 2.83） vs （9.12± 6.04） ; BDI： （5.41±3.92） vs（ 12.76 ± 8.04） ]. There WAS a significant difference in the scoreS of anxiety and depression between psychological intervention and non-psychological intervention （ P 〈 0.01 ）. Conclusions Biventricular pacing could improve anxiety and depression emotion in patients with cardiomyopathy. Early psychological intervention after operations has more significant influence on these patients. It could improve the quality of life, reduce medical burden, and improve the long-term survival rate.