肾移植患者的心理状态及其干预措施  

Mental state and its intervention in kidney transplantation patients

作　　者：孙颖 李静 刘雅英[2] 

机构地区：[1]辽宁省第三人民医院,辽宁省开原市112300 [2]四平市中心医院,吉林省四平市136000

出　　处：《中国组织工程研究与临床康复》2008年第5期921-924,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：目的:了解肾移植患者的心理健康状况及影响患者心理状态的因素,分析肾移植患者手术前后实施心理干预的有效性。方法:由本文第一作者检索Pubmed数据库和中国期刊全文数据库有关肾移植患者心理健康状况的相关文献,共检索到52篇文献,对资料进行初审。纳入标准:①肾移植患者心理健康状况及其影响因素。②肾移植患者的心理干预措施。排除标准:Meta分析类文章。最终纳入21篇文献进行分析讨论。结果:①肾移植患者手术前后的心理健康状况:肾移植围手术期患者常有不同程度的心理障碍,表现为焦虑、忧郁、不顺从医疗等。肾移植患者术后主要表现为紧张、烦躁、心理排斥、主观感觉异常及绝望心理。患者接受器官移植手术前后将出现一系列心理反应,导致心理上的排异反应,影响疾病的发展过程及预后。②影响肾移植患者心理状态的因素:肾移植患者的心理问题受移植肾在体内功能的影响很大,社会家庭的支持以及患者社会功能的恢复对患者的心理状态有极其重要的影响,同时由于免疫抑制剂的毒副作用和不良反应降低了患者的抵抗力,长期使用使患者承受巨大经济负担,从而引发心理问题。③心理干预措施:在肾移植术前对患者进行精神医学方面的评估及心理健康教育,可预防术后不良后果的发生,提高患者的治疗信心及手术成功率。于肾移植术后对患者进行个别心理指导,可减少不良心理反应的发生。结论:肾移植患者手术前后存在严重的心理问题,针对患者的心理问题及其成因为患者提供个性化的心理干预,有利于改善患者的心理状态,提高生活质量。AIM：To understand the mental health and influential factors in kidney transplantation patients and to analyze the efficacy of mental intervention before and after kidney transplantation. METHODS： Pubmed Database and China Journal Full-text Database were undertaken to identify relevant articles on mental health in kidney transplantation patients. Fifty-two articles were retrieved and checked primarily. Inclusive criteria： ①articles that were related to mental health and influential factors in kidney transplantation patients, and ②mental intervention studies in kidney transplantation patients. Exclusive criteria： Meta analysis studies. Finally, twenty-one articles were included. RESULTS： ①Mental health in patients before and after kidney transplantation： Patients in perioperative period had different degrees of psychologic obstacles such as anxiety, melancholy, noncompliance and so on. Patients after kidney transplantation developed tension, restlessness, psychological rejection, subjective paresthesia and despair. A series of psychic reaction occurred before and after transplantation, resulting in rejection and affecting development and prognosis. ②Influential factors in kidney transplantation patients： Mental problems in kidney transplantation patients were mainly affected by in vitro function of grafted kidney, social support and recovery of the social skill. Side effects and adverse reactions due to imunodepressant decreased the resistance of patients. Long-term usage brought about a high cost, which induced mental problems of the patients. ③Mental intervention： The evaluation of mental medicine and education of mental health before kidney transplantation could prevent postoperative side effects, elevate the therapeutic confidence and enhance the success rate of kidney transplantation. Individual mental guidance could reduce the occurrence of side mental reaction. CONCLUSION： Severe mental problems appeared in patients before and after kidney transplantation. Individual mental

关 键 词：肾移植 焦虑 抑郁 心理健康状况 影响因素 心理干预 

分 类 号：R692[医药卫生—泌尿科学]