ST段抬高型心肌梗死患者心理问题及心理护理干预的效果分析

Psychological Status in Patients with ST-segment Elevation Myocardial Infarction and the Effect of Psychological Nursing Intervention

目的分析ST段抬高型心肌梗死(STEMI)患者心理问题及心理护理干预效果。方法选取雅安市人民医院2014年1月—2016年1月收治的急性心肌梗死(AMI)患者188例,根据梗死类型分为非ST段抬高型心肌梗死(NSTEMI)组102例和STEMI组86例,采用随机数字表法将STEMI患者分为对照组42例和干预组44例。所有患者行经桡动脉或股动脉经皮冠状动介入治疗(PCI)及常规药物治疗,干预组患者在此基础上给予心理护理干预。比较NSTEMI组和STEMI患者症状自评量表(SCL-90)评分;比较对照组和干预组患者干预前、干预6个月后抑郁自评量表(SDS)评分、焦虑自评量表(SAS)评分、健康调查简表(SF-36)评分。结果 STEMI组患者躯体化评分、强迫评分、人际关系评分、抑郁评分、焦虑评分、敌对评分、恐惧评分、偏执评分、精神病性评分高于NSTEMI组(P<0.05)。干预前两组患者SDS评分、SAS评分比较,差异无统计学意义(P>0.05);干预6个月后干预组患者SDS评分、SAS评分低于对照组(P<0.05)。干预前两组患者身体功能评分、总体健康评分、活力评分、精神健康评分、社会功能评分、生理职能评分、身体疼痛评分、情感职能评分比较,差异无统计学意义(P>0.05);干预6个月后干预组患者身体功能评分、总体健康评分、活力评分、精神健康评分、社会功能评分、生理职能评分、身体疼痛评分、情感职能评分高于对照组(P<0.05)。结论与NSTEMI患者相比,STEMI患者心理问题较为突出;心理护理干预可有效减轻STEMI患者抑郁和焦虑情绪,改善患者生活质量及预后。

Objective To analyze the psychological status in patients with ST-segment elevation myocardial infarction and the effect of psychological nursing intervention. Methods A total of 188 patients with acute myocardial infarction were selected in the People＇s Hospital of Yaan from January 2014 to January 2016,and they were divided into A group（ with non ST-segment elevation myocardial infarction,n = 102） and B group（ with ST-segment elevation myocardial infarction,n = 86）according to infarctions types,and then patients in B group were divided into B1 group（ n = 42） and B2 group（ n = 44）according to random number table. All of the 188 patients received transradial approach or transfemoral approach PCI combined with conventional medical treatment,meanwhile patients of B2 group received extra psychological nursing intervention. SCL-90 score was compared between A group and B group; SDS score,SAS score and SF-36 score before intervention and 6 months after intervention were compared between B1 group and B2 group. Results Somatization disorder score,obsessive-compulsive symptom score,interpersonal relationship score,depression score,anxiety score,hostility score,fear score,bigotry score and psychoticism score in B group were statistically significantly higher than those in A group（ P〈0. 05）. No statistically significant differences of SDS score or SAS score was found between B1 group and B2 group before intervention（ P〉0. 05）,while SDS score and SAS score in B2 group were statistically significantly lower than those in B1 group 6 months after intervention（ P〈0. 05）. No statistically significant differences of physical function score, overall health score, vitality score, mental health score,social function score,role physical score,body pain score or role emotional score was found between B1 group and B2 group before intervention（ P〉0. 05）,while physical function score,overall health score,vitality score,mental health score,social function score,role physical score,body pain score and role emotional score in B2 group were statistically significantly higher than those in control group 6 months after intervention（ P〈0. 05）. Conclusion Compared with non ST-segment elevation myocardial infarction patients, psychological problems are more prominent in ST-segment elevation myocardial infarction patients; psychological nursing intervention can effectively relieve the depression emotion and anxiety emotion,improve the quality of life and prognosis.