冠状动脉造影患者围术期焦虑情况分析

Anxiety in Patients Undergoing Coronary Angiography

目的:分析患者在冠状动脉造影(CAG)前后是否存在焦虑及其变化情况,并探讨多种因素对围术期焦虑的影响,为CAG患者围术期的心理干预治疗提供依据。方法:入选于2012-12至2013-12在阜外心血管病医院心内科行CAG的住院患者379例。术前采集患者基本信息,同时采用中国A型行为问卷(TABQ)及焦虑自评量表(SAS)了解患者的人格特征和焦虑水平;造影次日再次评价焦虑水平。分析性别、年龄、病程、文化程度、A型人格、造影结果及血运重建治疗方案对围术期焦虑水平的影响。结果:CAG前及术后SAS评分高于中国常模,差异具有统计学意义(P<0.05)。CAG术前,女性SAS评分高于男性,差异具有统计学意义(P<0.05);CAG术后女性、年龄>50岁、病程>1年、初中及以下学历者SAS评分较高,差异具有统计学意义(P<0.05)。术后SAS评分较术前明显下降,但冠状动脉旁路移植术患者SAS评分下降不明显。多元线性回归分析发现造影术后与术前SAS评分的差值与文化程度负相关(P<0.05),与病程正相关(P<0.05)。结论:CAG检查可改善患者焦虑情绪,减轻患者心理负担,可有针对性的进行围术期心理干预。

Objective：To identify the risk factors of anxiety disorders among patients undergoing coronary angiography （CAG） and to determine whether the decision of revascularization affect anxiety level following coronary angiography. Methods：A total of 379 patients undergoing CAG in Fuwai Hospital from Dec. 2012 to Dec. 2013 were invited to participate this study. A data-collecting form, which included questions about demographic features, health history, Type A Behavior Questionnaire （TABQ） and Self Rating Anxiety Scale （SAS）, was completed by the participants on the day before and the day after CAG. Result：Among these patients, SAS score of both before and the day after CAG were higher than Chinese normative SAS score. Female patients had a higher SAS score level than male patients （40.57±9.53 vs 38.26±9.61, P〈0.05） before CAG. Patients with these factors of female, over 50 years old, duration of coronary artery disease over 1 year, lower education level had a higher SAS score after CAG. SAS score declined signiifcantly after CAG except those scheduled to receive CABG. Multivariable linear analysis found the D-value between SAS scores before and after CAG was negative correlated with degree of education and positive correlated with the duration of coronary artery disease. Conclusion：The anxiety level decreased after CAG, except those who need coronary revascularization surgery.