心理疗法在植入心律转复除颤器患者中的运用

Application of psychological therapy to patients with implantable cardioverter defibrillator

目的观察运用认知行为疗法(CBT)及接受与承诺疗法(ACT)在植入型心律转复除颤器(ICD)患者的焦虑及忧郁等心理症状的效果。方法将66例植入ICD的患者随机分为心理治疗组(观察组34例)及常规治疗组(对照组32例),观察组运用CBT及ACT的原理,通过端正认知、积极面对现实、互相帮助等方法进行心理治疗,使患者从逃避症状的心理转化为顺其自然地顺从症状及接受治疗。对照组仅进行常规复查及心理辅导。结果观察组患者发生抑郁及焦虑症者少且程度轻;ICD放电次数治疗组有下降趋势。结论运用CBT结合ACT治疗可减少植入ICD的患者忧虑、焦虑等精神障碍的发生,是一种安全、有效的非药物疗法,有助于防止及缓解患者恐惧、焦虑及忧郁等不良心理障碍,

【Objective】 To observe the effect of cognition-behavior therapy（CBT） combined with acceptance and commitment therapy（ACT） on depression and anxiety in patients with implantable cardioverter defibrillator（ICD）. 【Methods】 Sixty-six cases of ICD patients were randomly divided into psychological therapy group（34 cases） and control group（32 cases）. By the theory of CBT and ACT, psychological therapy was carried out in the way of correcting cognition, facing the reality, helping each other in medical treatment or social life and other manners in order to change the psychological action of escaping symptoms to facing the real facts and accepting treatment compliantly. In the control group, only ordinary fel low-up was given.【Results】 In the psychological therapy group, the incidence of depression and anxiety symptoms was lower and the degree of the psychological symptom was better than those of the control group, while there was a tendency to shock less by ICD. 【Conclusions】 CBT combined with ACT is effective in relieving psychological disorders in patients with ICD.