成人心脏手术患者合并焦虑和抑郁的研究进展

Research progress of anxiety and depression in adult patients undergoing cardiac surgery

焦虑是一种带有恐惧成分的强烈行为和心理反应,抑郁是一种以心境的高涨或低落为主的精神障碍,两种症状均伴有认知和行为的改变,是心脏病患者常见的共患病。心脏手术是引发患者特定情绪和生理反应的重要因素之一,术后持续或首发的抑郁和焦虑不仅会增加手术并发症、近期或远期的死亡率和医疗费用等,还会严重影响患者的社会功能和生活质量。随着生物-心理-社会医学模式的转变,对心脏手术患者进行围术期的心理状态和生物学风险评估必不可少。本文对心脏手术患者焦虑和抑郁的特点、相关机制及治疗干预等进行综述。

Anxiety is a strong behavioral and psychological reaction with fear components,while depression is a mental disorder dominated by high or low mood,both of which are accompanied by cognitive and behavioral changes,and are common comorbidities in patients with heart disease.Cardiac surgery is one of the important factors which trigger specific emotional and physiological reactions of patients.Persistent or initial depression and anxiety after surgery will not only increase surgical complications,short-or long-term mortality and medical costs,but also seriously affect patients'social function and quality of life.With the transformation of bio-psycho-social medical model,it is necessary to evaluate the perioperative psychological state and biological risk of patients undergoing cardiac surgery.This article reviews the characteristics,related mechanisms and therapeutic interventions of anxiety and depression in patients undergoing cardiac surgery.