冠状动脉旁路移植围手术期抑郁、焦虑状况调查  

Peri-operative Depression and Anxiety of Coronary Artery Bypass Grafting

作　　者：李西慧[1] 王忠杰[2] 肖锋[1] 张明礼[1] 李忠[1] 李岩[1] 

机构地区：[1]北京大学第一医院心脏外科,北京100034 [2]北京邮电大学医院精神心理科,北京100876

出　　处：《中国心理卫生杂志》2007年第3期186-189,共4页Chinese Mental Health Journal

基　　金：北京大学第一医院科研基金(2005970025)

摘　　要：目的:调查行冠状动脉旁路移植术(CABG)的患者围术期抑郁、焦虑的发生率及相关因素。方法:2005年7月至2006年5月,以连续行择期CABG术的73例患者为研究对象,分别在术前1周内和术后出院前1天使用ZUNG氏抑郁自评量表和焦虑自评量表进行评分。结果:手术前共有21例(28.8%)阳性患者,其中11例患者存在抑郁状态,7例患者同时存在抑郁和焦虑状态,3例存在焦虑状态。手术后共有34例(46.6%)阳性患者,其中18例患者存在抑郁状态,13例患者同时存在抑郁和焦虑状态,3例存在焦虑状态。SDS标准分术后(47.9±10.0)高于术前(43.7±10.0,t=3.55,P=0.001),焦虑评分术后(41.6±8.5)高于术前(39.3±7.4,t=2.20,P=0.031)。术前发生抑郁焦虑的患者受教育少(8±3/10±3年,t=2.18,P=0.032),术后焦虑抑郁组中术前就存在抑郁焦虑的比例高(16/34对5/39,χ2=10.391,P=0.001),术前多次心肌梗死的4例都在术后抑郁焦虑组(4/34比0/39,P=0.043);术前抑郁焦虑情绪对术后围手术期恢复没有影响。术后是否发生抑郁焦虑者住院时间没有显著差别。结论:CABG患者围术期抑郁焦虑状态有较高的发生率,术后情绪更差。受教育程度低是术前情绪不良的危险因素,病情重是术后情绪不良的危险因素。Objective： To investigate the peri-operative incidence of depression and anxiety symptoms of coronary artery bypass grafting （CABG） . Methods： 73 patients, who underwent scheduled consecutive CABG between July 2005 and May 2006, were assessed with self-rating depression scale （SDS） and self-rating anxiety scale （SAS） before operation and before leaving hospital. Results： 21 patients （28.8%） had depression and/or anxiety symptoms before CABG, including 11 patients with depression, 7 patients with both depression and anxiety and the other 3 patients had anxiety symptoms. 34 patients （46. 6% ） had depression and/or anxiety symptoms after CABG, including 18 patients who had depression, 13 patients had both depression and anxiety symptoms and the other 3 patients had anxiety symptoms. The SDS score （47.9 ± 10. 0） after surgery was significantly higher than that before surgery （43.7 ± 10） , t =3.55, P =0. 001. The SAS score after surgery （41.6 ± 8.5 ） was significantly higher than that before surgery （ 39. 3 ± 7.4） , t = 2. 20, P =0. 031. Patients with bad mood before operation had lower educational levels （ 8 ± 3/10±3, t =2. 18, P =0. 032） . Four patients had multiple myocardial infarctions, all of them were in the anxietydepression group postoperatively （4/34 vs 0/39, P = 0. 043 ） . There was no difference in post-operative length of hospital stay between the two groups. Conclusions： The peri-operative incidence of depression and anxiety of CABG patients was very high and even higher after surgery. Less education is a risk factor for preoperative depression and anxiety states, multiple infarctions is a risk factor of post operative anxiety and depression.

关 键 词：抑郁 焦虑 前瞻性研究 冠状动脉旁路移植术 围手术期 

分 类 号：R749.2[医药卫生—神经病学与精神病学]