焦虑抑郁对再造手指患者发生血管危象的影响及干预  

Influence of Anxiety and Depression on Vascular Crisis of Reconstructed Finger

作　　者：陈淑琴[1] 赵崇梅[2] 朱秀美[3] 宋海燕[4] 张郑荣[4] 

机构地区：[1]中国人民解放军第401医院全军手外科中心处,山东青岛266071 [2]中国人民解放军第401医院护理部,山东青岛266071 [3]中国人民解放军第401医院医务处,山东青岛266071 [4]中国人民解放军第401医院全军手外科中心,山东青岛266071

出　　处：《护理学杂志》2005年第16期69-71,共3页

摘　　要：目的探讨焦虑、抑郁对再造手指患者发生血管危象的影响及干预。方法对108例(140指)行手指再造患者采用医院焦虑抑郁量表(HAD)进行调查,并依此分为阳性组(83例,108指)和阴性组(25例,32指),再用随机方法将阳性组分为A组(26例,32指)、B组(28例,37指)和C组(29例,39指)。阴性组和A组采用常规治疗护理;B组在此基础上加用复方冬眠合剂治疗5d;C组在常规治疗护理方法上进行心理疏导干预。观察阳性患者A、B、C3组出院时HAD阳性率和4组患者术后血管危象发生率。结果血管危象发生率阴性组与A组比较,差异有显著性意义(P<0.05);A组与B组及C组比较,均P<0.05,差异有显著性意义;B组与C组比较,P>0.05,差异无显著性意义;阴性组与B组及C组比较,均P>0.05,差异无显著性意义;A、B、C3组出院时HAD阳性率,A组与B组比较,P>0.05,差异无显著性意义;A组与C组、B组与C组比较,均P<0.01,差异有显著性意义。结论焦虑抑郁情绪可明显增加再造手指血管危象的发生率;药物干预作用虽能降低再造手指血管危象发生率,但不能彻底消除患者的焦虑抑郁症状;有针对性地进行心理疏导干预能有效减轻患者的焦虑抑郁症状,降低血管危象发生率。Objective To explore the influence of anxiety and depression on vascular crisis that occurred in finger reconstruction and effective interventive measures. Methods One hundred and eight cases of finger reconstruction were examined by using hospital anxiety and depression （HAD） scale and then divided into positive group and negative group. The patients in the positive group were randomly subdivided into group A, B and C. In negative group and group A, patients were treated with routine nursing care. The patients in group B were given intravenous compound hibernation mixture for 5 days. With the patients in group C, psychological releasing measures were used plus routine nursing care. The incidence of postoperative vascular crisis of all 4 groups were recorded. The patients of groups A, B and C were observed against HAD once more before being discharged from hospital. Results Significant difference in the incidence of vascular crisis was found between the negative group and group A （P〈0.05）. Significant differences existed among groups A and B, A and C （P〈0.05 for all） and no significant differences were found between group B and group C （P〉0.05） and between negative group and group B or group C （P〉0.05 for all）. No significant difference existed in the positive results of of HAD before discharge between group A and group B （P〉0.05）. Very significant differences were found between group A and group C, and between group B and group C （P〈0.01 for all）. Conclusion Anxiety and depression could obviously increase occurrence rate of postoperative vascular crisis in patients undergoing finger reconstruction. Though drug could lower the occurrence rate, but it couldn＇t completely solve the problems of anxiety and depression. Psychological approach is an effective interventive measure to minimize anxiety and depression and reduce vascular crisis.

关 键 词：再造手指 血管危象 焦虑 抑郁 护理干预 

分 类 号：R473.6[医药卫生—护理学]