心理干预改善子宫全切术患者焦虑、抑郁情绪的临床观察  

The Study of Interventions which Ameliorated Psychiatric Disorders in the Patients Undergoing Total Hysterectomy

作　　者：徐琳[1] 周争立[2] 单朝屏[1] 杨映芳[1] 

机构地区：[1]昆明医学院第一附属医院妇产科,昆明650032 [2]云南省第一人民医院妇科,昆明650032

出　　处：《昆明医学院学报》2004年第3期56-59,共4页Journal of Kunming Medical College

摘　　要：目的 :了解 4 5岁以下的子宫肌瘤患者在腹式子宫全切术术前及术后焦虑、抑郁的变化 ,以及心理干预对其产生的影响 .方法 :对符合入组条件的 90例患者于入院时、术前 1d、术后半年进行SAS、SDS自评量表评估 .随机将 4 6例作为干预组 ,除行腹式子宫全切术外 ,在围手术期行心理干预 ,干预方法 :支持性心理治疗、健康教育、个别深入的心理治疗、家庭和社会支持治疗等 ;对照组 4 4例仅采取手术治疗 .观察两组治疗前后焦虑、抑郁的变化 .结果 :4 5岁以下的子宫肌瘤患者在子宫全切术前、术后存在明显的焦虑、抑郁症状 .心理干预能明显改善焦虑、抑郁 ,并且改善焦虑于术前效果最明显 ,改善抑郁于术后半年效果最明显 .结论 :应重视并了解子宫肌瘤患者对子宫全切术存在的不良心理 。Objective:The purpose of this study is to know what changes of anxiety and depression in the patients who below 45 years old and undergoing total hysterectomy for uterine leiomyomas, and what effects of interventions on the patients' mood. Methods: 90 women were selected by the coincidence of condition, and all were evaluated by two different psychological tests named Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) at the first day of hospitalization , a day before operation, and half a year after operation. 46 women were chosen randomly from 90 women as the intervention group. They received both total hysterectomy and interventions which included supportive therapy, health education, individual psychotherapy, and family and social supportive therapy during hospitalization. 44 women were only received total hysterectomy as the control group .Two groups’ changes of anxiety and depression were observed. Results: There were obvious mood disturbances in the patients who below 45 years old and undergoing total hysterectomy for uterine leiomyomas. Interventions can ameliorate women's anxiety and depression significantly (P<0.05). The effect of interventions ameliorating anxiety was most apparent before operation, and ameliorating depression was most apparent after operation. Conclusion: These results suggest that it is important for gynecologists to recognize and find out patient's psychiatric disorders associated with hysterectomy for uterine leiomymas ,and then they can take active interventions to reduce or even eliminate patient's psychiatric disorders.

关 键 词：患者 心理干预 焦虑 子宫全切术 抑郁 子宫肌瘤 术前 结论 不良心理 变化 

分 类 号：R473[医药卫生—护理学] R713.42[医药卫生—临床医学]