内镜下多次食管胃静脉曲张治疗对焦虑抑郁的影响及干预措施

The influence of endoscopic treatments for esophagogastric variceal hemorrhage to anxiety and depression level in patients with liver cirrhosis and treatment measures investigatios

目的探讨内镜下多次食管胃静脉曲张治疗对肝炎肝硬化患者的焦虑抑郁水平的影响,并探讨氟哌噻吨美利曲辛对提高患者依从性的作用。方法采用综合性医院焦虑抑郁量表(HAD)和基本资料问卷表对3年内多次(>3次)接受内镜下食管胃静脉曲张治疗术的76例患者每次治疗前进行问卷调查,3次调查完成后对伴有焦虑抑郁状态的患者加用氟哌噻吨美利曲辛治疗。焦虑自评量表(SAS)评分及抑郁自评量表(SDS)评分用来评价患者焦虑抑郁水平,SAS评分、SDS评分及依从性用来评价氟哌噻吨美利曲辛治疗效果。基本资料问卷表用来调查患者的一般情况。结果在随访的3年内,76例患者中存在焦虑状态的29例,抑郁状态的34例;患者的焦虑抑郁水平与经济状况(χ2=9.991,Ρ=0.005)、病程长短(χ2=7.164,Ρ=0.007)、有无并发症(χ2=24.683,Ρ=0.000)等因素相关;随着治疗次数的增加,SAS及SDS评分逐渐升高,有统计学意义(P<0.05)。氟哌噻吨美利曲辛可改善患者焦虑抑郁状态,愿意继续下次治疗的人数由15.8%提高到40.8%(P<0.05)。结论多次接受肝硬化内镜下食管胃静脉曲张治疗的患者易发生焦虑抑郁状态,并与诸多因素有关。氟哌噻吨美利曲辛可改善患者焦虑抑郁状态,提高患者的依从性。

Objective To investigate the anxiety and depression levels in patients with endoscopic treatment for esophagogastric variceal hemorrhage and to discusses the role of Flupentixol and Melitracen to improve compliance. Methods General Hospital Anxiety and Depression Scale （HAD）, and the basic information questionnaire were adopted to conduct questionnaire survey per treatment forward on 76 esophagogastric variceal hemorrhage patients with many times （〉 3 times） endoscopic treatment. Self-rating anxiety scale （SAS） and self-rating depression scale （SDS） score were used to assessed the patients＇ anxiety and depression; SAS , SDS score and compliance were used to assessed therapeutic effect of Flupentixol and Melitracen. Using self-edited questionnaire for Investigating the patients＇ general information and information. Results In 3 years of follow-up period, 29 patients suffered from anxiety and 34 patients suffered from depression. The level of anxiety and depression of the patients has something to do with economic conditions （X2=9.991, P=0.005）, the duration of the diseases （X2=7.164, P=0.007）, complication （x2=24.683, P=0.000）etc;Along with the increase of number of treatment, SAS and SDS score gradually raised, and there is statistically significant （P〈0.05）. Flupentixol and Melitracen can improve patients＇ anxiety depression state, and compliance increased to 40.8% from 15.8%（P〈0.05）. Conclusion Patients with many times endoscopic treatment of esophagogastric variceal hemorrhage are prone to suffering from anxiety and/or depression, and many factors related.Flupentixol and Melitracen has obvious treatment role to anxiety and depression state and can improve the patient compliance.