心脏手术后患者合并抑郁和焦虑状况分析

Analysis of Depression and Anxiety in Patients after Cardiac Surgery

目的 观察心脏手术后患者的焦虑和/或抑郁状况,为患者的心理健康管理和术后康复提供依据。方法 选择2021年9-12月接受心脏手术后的患者为研究对象,分别使用Zung氏焦虑自评量表(SAS)及Zung氏抑郁自评量表(SDS)评估研究对象的焦虑及抑郁状况。采用方差分析、χ^(2)检验进行组间比较,并以无序多分类logistic回归模型和分层分析探讨相关因素。结果 在146例心脏手术后患者中,单纯焦虑2例(1.4%),单纯抑郁54例(37.0%),焦虑合并抑郁40例(27.4%)。多因素分析结果显示,与中青年相比,老年患者(≥60岁)心脏手术后的焦虑合并抑郁风险更高(OR:2.737,95%CI:1.121~6.686,P=0.027),男性患抑郁风险高于女性(OR:2.721,95%CI:1.022~7.242,P=0.045)。分层分析结果显示,老年男性患者术后抑郁风险高于女性,老年超重者(BMI≥24 kg/m~2)的焦虑合并抑郁风险低于老年非超重者;在男性、接受外科手术、BMI <24 kg/m^(2)者中,老年患者的焦虑合并抑郁风险均高于中青年患者(P<0.05)。结论 心脏手术后患者有可能存在焦虑和/或抑郁状况,尤其老年男性患者,应予以及时评估和心理支持。

Objective To investigate the anxiety and depression of patients after cardiac operation,and to provide suggestions for mental health management and postoperative rehabilitation of patients.Methods Individuals who underwent heart operation were enrolled during September to December,2021.Anxiety symptoms were evaluated using Zung’s Self-rating Anxiety Scale(SAS)and depression symptoms using Zung’s Self-rating Depression Scale(SDS).Between-group differences were assessed by analysis of variance,and chi-square test.A disordered multi-classification Logistic regression model and stratified analysis were used to determine the related factors.Results Of the 146 patients after cardiac operation,2(1.4%) had only anxiety,54(37.0%) had only depression,and 40(27.4%) had both.After cardiac operation,elderly patients(≥60 years old) had a higher risk of anxiety combined with depression(OR:2.737,95%CI:1.121-6.686,P =0.027) than younger patients;Male had a higher risk of only depression(OR:2.721,95%CI:1.022-7.242,P =0.045) than women.Stratified analysis showed that the risk of postoperative depression in elderly male patients was higher than that in female patients.The risk of anxiety combined with depression in elderly overweight patients was lower than that in non-overweight patients.Among males,patients undergoing surgery,or patients with BMI < 24 kg/m^(2),the risks of anxiety and depression in elderly patients were higher than those in young and middle-aged patients(P <0.05).Conclusions Patients may have anxiety and/or depression after cardiac surgery,especially elderly male patients,should be timely evaluated and given psychological support.