心理干预对PCNL术后患者负性情绪及生活质量的影响

The effect of psychological intervention on anxiety,depression and quality of life of patients with upper urinary calculus after PCNL

目的探讨心理干预对上尿路结石患者经皮肾镜碎石术(PCNL)术后的焦虑抑郁情绪、生活质量的影响。方法选择2018年7月~2019年10月我院接诊的100例上尿路结石患者,通过随机数表法分为观察组和对照组,每组50例。对照组在PCNL围术期给予常规处理措施,观察组在对照组基础上,联合术前、术中及术后的心理干预。比较两组手术前后疼痛视觉模拟评分法(VAS)、焦虑自评量表(SAS)、抑郁自评量表(SDS)、生活质量综合评定问卷(GQOLI-74)的变化。结果术后1h、6h、12h及24h时,观察组VAS评分均明显比对照组低[(3.03±0.54)分vs(3.40±0.47)分,(2.84±0.29)分vs(3.12±0.45)分,(2.51±0.25)分vs(2.86±0.33)分,(2.30±0.28)分vs(2.64±0.21)分](P<0.05);术后1周时,观察组SAS评分、SDS评分比均比对照组低[(43.03±4.72)分vs(48.21±4.21)分,(48.04±5.21)分vs(53.21±4.83)分](P<0.05);术后1个月时,观察组GQOLI-74量表中躯体功能、心理功能、社会功能评分均高于对照组[(18.12±2.47)分vs(14.04±1.84)分,(17.49±1.85)分vs(13.83±1.53)分,(17.84±2.04)分vs(13.27±1.84)分](P<0.05)。结论心理干预有助于缓解上尿路结石患者PCNL术后的疼痛及焦虑抑郁情绪,改善生活质量。

Objective To study the effect of psychological intervention on anxiety,depression and quality of life of patients with upper urinary calculus after percutaneous nephrolithotripsy(PCNL).Methods From July 2018 to October 2019,100 upper urinary calculus patients in our hospital were selected,according to the random number table,they were divided into the observation group and the control group,40 cases in each group.The control group was given routine treatment measures in the perioperative period of PCNL,while the observation group was treated with preoperative,intraoperative and postoperative psychological intervention on the basis of the control group.The changes of visual analogue scale(VAS),self rating Anxiety Scale(SAS),self rating Depression Scale(SDS),and comprehensive quality of life questionnaire(GQOLI-74)were compared between the two groups before and after operation.Results At after operation 1 h,6 h,12 h and 24 h,the VAS score in the observation group was significantly lower than those of the control group[(3.03±0.54)scores vs(3.40±0.47)scores,(2.84±0.29)scores vs(3.12±0.45)scores,(2.51±0.25)scores vs(2.86±0.33)scores,(2.30±0.28)scores vs(2.64±0.21)scores](P<0.05).After one week of operation,the SAS and SDS scores in the observation group were lower than those in the control group[(43.03±4.72)scores vs(48.21±4.21)scores,(48.04±5.21)scores vs(53.21±4.83)scores](P<0.05).After operation one month,the scores of physical function,psychological function and social function scores in GQOLI-74 in the observation group were higher than those in the control group[(18.12±2.47)scores vs(14.04±1.84)scores,(17.49±1.85)scores vs(13.83±1.53)scores,(17.84±2.04)scores vs(13.27±1.84)scores](P<0.05).Conclusion Psychological intervention can relieve pain,anxiety and depression in patients with upper urinary tract stones after PCNL,improve their the quality of life.