永久起搏器植入术后急性期老年患者抑郁倾向及影响因素分析

Analysis of depression tendency in elderly patients in acute phase post permanent pacemaker implantation

目的对永久起搏器(PPM)植入术后3个月的老年患者进行量表评估,分析患者出现抑郁倾向的影响因素。方法收集2011年8月至2012年8月由笔者实施的PPM手术患者的基本信息,询问所有患者术后所担心的问题。在术后3个月用Zung抑郁自评量表评估,超过53分判为具有抑郁倾向。结果共收集PPM手术患者130例,其中65岁以上老年患者92例,占70.7%。老年患者中,男性48例,占52.2%,其中85例(92.4%)患者为首次植入,6例(6.5%)为第二次植入,1例(1.1%)为第三次植入。术后3个月量表评估27.2%(25/92)分值超过53分,老年患者中出现抑郁倾向的比例高于非老年患者。术后引起患者不安的问题依次为术后出现新的不适感觉(51.1%)、担心起搏器不能正常工作(47.8%)、担心起搏器不能完全解决自己的症状(30.4%)、担心自己活动会影响起搏器的工作(25.0%)。不同性别、是否具有高血压、糖尿病、冠心病以及植入次数对出现抑郁倾向的比例没有影响。不同年龄组之间的老年患者出现抑郁倾向的比例有差异(P<0.05)。结论 PPM患者有抑郁倾向的发生率不低,其发生与年龄的增加有关。

Objective To evaluate depressive tendencies of patients at three months after implantation of permanent pacemarker（PPM）. Method To collect data from patients who were subject to PPM implantation from August 2011 to August 2012 and evaluate their depression tendency at three months after implantation with Zung self-rating scale （SDS）. SDS score over 53 was recognized as depression tendency. Results A total of 130 patients with PPM implantation were enrolled, including 92 （70.7%） elderly patients （ above 65 years old）. Of the 92 elderly patients, 48 （52.2%） were males, and 85 patients （92.4%） were implanted for the first time, 6 （6.5%） for the second time, and 1 （ 1.1% ） for the third time. According to SDS scores at 3 months after implant＇~tion, elderly patients （27.1% ） had higher tendency to de- velop depression. The triggers of post PPM depression included new discomforts （51.1%）, concern of malfunction （47. 8% ） and non-function （30.4%） of pacemaker and affecting the function of the pacemaker by daily routine activities（25. 0% ）. Depression tendency was not found to be significantly associated with gender, hypertension, diabetes, coronary heart disease and number of implantations. However, elderly patients of different age groups showed different tendencies in developing into depression（P〈0.05）. Conclusion PPM patients are relatively easy to have depression tendency, and the incidence is associated with increasing age.