不稳定型心绞痛患者择期行经皮冠状动脉介入治疗后发生创伤后应激障碍现状研究

Study on the current status and influencing factors of post-traumatic stress disorder in patients with unstable angina pectoris undergoing selective percutaneous coronary intervention

目的 分析不稳定型心绞痛患者择期行经皮冠状动脉介入治疗(PCI)后创伤后应激障碍(PTSD)发生情况及有关影响因素。方法 选取2021年2月至2022年2月该院收治的择期行PCI的不稳定型心绞痛患者120例,统计其术后PTSD发生率;另收集患者年龄、性别等资料,分析患者PCI后PTSD发生的有关影响因素。结果 120例患者中术后共有27例发生PTSD,发生率为22.50%(27/120);年龄、性别、体重指数、高脂血症、文化程度、婚姻状况、家庭月收入、医疗费用来源,以及有糖尿病、高血压、吸烟、饮酒史均与行PCI的不稳定型心绞痛患者术后PTSD的发生无关,差异均无统计学意义(P>0.05);社会支持、疾病恐惧进展感觉、创伤后成长水平、应对方式均与行PCI的不稳定型心绞痛患者术后PTSD的发生有关,差异均有统计学意义(P<0.05);社会支持不良、疾病恐惧进展感觉强烈、创伤后成长水平低、消极应对均为行PCI的不稳定型心绞痛患者术后PTSD发生的独立危险因素(偏回归系数=2.591、1.812、1.995、2.324,优势比=13.348、6.120、7.350、10.214,95%可信区间=4.224~42.178、2.386~15.700、2.688~20.101、3.513~29.699,P<0.05)。结论 不稳定型心绞痛患者择期行PCI后PTSD发生风险较高,而社会支持不良、疾病恐惧进展感觉强烈、创伤后成长水平低、消极应对是发生PTSD的独立危险因素。

Objective To analyze the incidence and related influencing factors of post-traumatic stress disorder(PTSD)in patients with unstable angina pectoris who undergoing selective percutaneous coronary intervention(PCI).Methods A total of 120 patients with unstable angina pectoris who underwent elective PCI in the hospital from February 2021 to February 2022 were selected,and the incidence of postoperative PTSD was calculated.In addition,the data of patients′age,gender,and other data were collected to analyze the relevant influencing factors of PTSD after PCI.Results Among 120 patients,27 cases developed PTSD after surgery,with an incidence rate of 22.50%(27/120);Age,gender,body mass index(BMI),hyperlipidemia,diabetes,hypertension,education level,marital status,family monthly income,source of medical expenses,and history of diabetes,hypertension,smoking and drinking were not related to the occurrence of PTSD after PCI in patients with unstable angina pectoris,and the difference were not statistically significant(P>0.05);Social support,fear of disease progression,post-traumatic growth level,and coping styles were all associated with the occurrence of postoperative PTSD in patients with unstable angina pectoris undergoing PCI,and the differences were statistically significant(P<0.05).Poor social support,strong fear of disease progression,low post-traumatic growth and negative coping were independent risk factors for PTSD in patients with unstable angina pectoris after PCI(β=2.591,1.812,1.995,2.324;OR=13.348,6.120,7.350,10.214,95%CI=4.224-42.178,2.386-15.700,2.688-20.101,3.513-29.699,P<0.05).Conclusion Patients with unstable angina pectoris who choose to undergo PCI have a higher risk of PTSD,while poor social support,strong fear of disease progression,low post traumatic growth level,and negative coping are the independent risk factors for PTSD.