防御体系干预对腹主动脉瘤围手术期患者心理状态及预后的影响

Effect of defense system intervention on the psychological state and prognosis of perioperative patients with abdominal aortic aneurysm

目的探讨防御体系干预对腹主动脉瘤围手术期患者心理状态及预后的影响。方法选取2017年8月至2019年8月南京医科大学第一附属医院收治的68例进行手术治疗的腹主动脉瘤患者,采用随机数字表法将患者分为观察组和对照组,每组34例。对照组患者实施常规干预,观察组患者实施防御体系干预。使用90项症状自评量表(SCL-90)评估并比较两组患者的心理状态。比较两组患者的住院时间、手术时间、住院费用。比较两组患者术后并发症的发生情况,包括肾脏衰竭、心肌梗死、内漏、腹主动脉瘤破裂及休克。比较两组患者干预前和干预后1个月的血脂水平,血脂指标包括血清总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL)及高密度脂蛋白(HDL)。结果干预后,两组患者SCL-90中躯体、强迫、人际关系、抑郁、焦虑维度的评分均低于本组干预前,差异均有统计学意义(P﹤0.05)。干预后,观察组患者SCL-90中躯体、强迫、人际关系、抑郁、焦虑维度的评分均低于对照组患者,差异均有统计学意义(P﹤0.05)。观察组患者的住院时间、手术时间均明显短于对照组患者,住院费用明显少于对照组患者,差异均有统计学意义(P﹤0.01)。观察组患者的术后并发症总发生率为5.88%(2/34),低于对照组患者的23.53%(8/34),差异有统计学意义(P﹤0.05)。干预后,两组患者的TC、TG、LDL、HDL水平均优于本组干预前,且观察组患者的TC、TG、LDL、HDL水平均优于对照组患者,差异均有统计学意义(P﹤0.05)。结论防御体系干预能够有效改善腹主动脉瘤围手术期患者的心理状态,缩短住院时间、手术时间,减少住院费用,降低术后并发症的发生率,值得临床推广应用。

Objective To investigate the effect of defense system intervention on the psychological state and prognosis of perioperative patients with abdominal aortic aneurysm.Method A total of 68 patients with abdominal aortic aneurysm who underwent surgical treatment at the First Affiliated Hospital of Nanjing Medical University from August 2017 to August 2019 were selected and divided into observation group and control group using random number table method,with 34 cases in each group.Patients in the control group received conventional intervention,while patients in the observation group received defense system intervention.Use the Symptom Checklist 90(SCL-90)to evaluate and compare the psychological status of two groups of patients.Compare the length of hospitalization time,operation time,and hospitalization expenses between two groups of patients.Compare the incidence of postoperative complications between two groups of patients,including renal failure,myocardial infarction,internal leakage,rupture of abdominal aortic aneurysm,and shock.Compare the blood lipid levels of two groups of patients before and one month after intervention,including serum total cholesterol(TC),triacylglycerol(TG),low-density lipoprotein(LDL),and high-density lipoprotein(HDL).Result After the intervention,the scores of the physical,obsessive-compulsive,interpersonal,depression,and anxiety dimensions of the SCL-90 scale of the two groups of patients were all lower than before the intervention,and the differences were statistically significant(P<0.05).After the intervention,the scores of the physical,obsessive-compulsive,interpersonal,depression,and anxiety dimensions of the SCL-90 scale of the patients in the observation group were lower than those of the patients in the control group,and the differences were statistically significant(P<0.05).The hospitalization time and operation time of the patients in the observation group were significantly shorter than that of the patients in the control group,and the hospitalization expenses were significantly less than those of the patients in the control group,and the differences were statistically significant(P<0.01).The total incidence rate of postoperative complications in the observation group was 5.88%(2/34),which was lower than 23.53%(8/34)in the control group,and the difference was statistically significant(P<0.05).After intervention,the levels of TC,TG,LDL,and HDL in both groups of patients were better than those before intervention,and the levels of TC,TG,LDL,and HDL in the observation group were better than those in the control group,and the differences were statistically significant(P<0.05).Conclusion Defense system intervention that is worthy of clinical promotion and application could effectively improve the psychological state of perioperative patients with abdominal aortic aneurysm,shorten hospitalization time,operation time,reduce hospitalization expenses and the incidence of postoperative complications.