认知行为干预对急性冠脉综合征患者焦虑抑郁的影响

Effect of Cognitive Behavioral Intervention on Anxiety and Depression of Patients with Acute Coronary Syndrome

【目的】通过对急性冠脉综合征（Acute Coronary Syndrome，ACS）患者进行心理状态评估及干预，评价认知行为干预在ACS患者护理中的作用。【方法】本研究连续选取2011年10月至2012年2月期间，在同济大学附属第十人民医院CCU住院的174例ACS患者，分为干预组和对照组，在各组中进行临床特点比较，完成抑郁自评量表（SDS）和焦虑自评量表（SAs）测评，干预组进行认知行为干预3个月后进行再次心理评估，观察SDS、SAS分值变化以及预后情况。【结果】在ACS患者中进行干预对照研究结果显示，干预组患者的临床症状缓解较对照组明显，且二次心理量表测评抑郁焦虑程度较前明显好转。【结论】ACS患者中有相当一部分存在焦虑抑郁情绪，认知行为干预对其症状缓解起到积极作用，需重视认知行为干预。

[Objective] To assess the role of cognitive behavior intervention in the nursing of patients with acute coronary syndrome （ACS） through the evaluation and intervention of mental state of ACS patients. [Methods] In the study, 174 ACS inpatients in CCU of the tenth people＇s hospital affiliated to Tongji universi- ty from Oct. 2（）11 to Feb. 2012 were continuously chosen. All patients were divided into intervention group and control group. Clinical characteristics were compared between two groups. Self-rating depression scale （SDS） and self-rating anxiety scale（SAS） assessment were completed. Psychological assessment was per- formed for the intervention group 3 months after cognitive behavioral intervention. The changes of SDS and SAS scores and prognosis were observed. [Results] The results of the comparative study of the intervention for ACS patients showed that the remission of clinical symptoms of patients in intervention group was more ob- vious than that in control group, and anxiety and depression by two psychological assessments were improved compared with before intervention（SDS score： 0. 468_--＋-0. 069 vs 0. 437~0. 067, P =0. 002; SAS score： 32.70 I-_4. 044 vs 27.53!4. 96, P 〈0. 001）. [Conclusion] Some ACS patients have anxiety and depression. The follow-up results show that the anxiety and depression of patients in intervention group after cognitive behav- ioral intervention are obviously improved. Cognitive behavior intervention plays a positive role in symptom re- mission, and should be emphasized.