冠状动脉旁路移植术患者手术前后抑郁症对患者生存质量的影响  

Depression before and after operation in patients undergoing coronary artery bypass grafting and the effect thereof on quality of life

作　　者：王玺胜[1] 梅运清[1] 李爱萍[2] 季强[1] 孙益峰[1] 朱辰[1] 迟良杰[1] 胡大一[2] 

机构地区：[1]同济大学心肺血管中心心肺血管疾病研究所附属同济医院胸心血管外科,上海200065 [2]同济大学医学院同济大学心肺血管中心心肺血管疾病研究所

出　　处：《中华医学杂志》2008年第46期3283-3286,共4页National Medical Journal of China

摘　　要：目的调查行冠状动脉旁路移植术（CABG）患者手术前、后抑郁症的发生和变化以及生存质量（QOL）情况，并研究抑郁症对CABG患者生存质量的影响。方法138例CABG患者在手术前一周内，术后1、3、6个月进行Beck抑郁问卷的自我评测并计分；并在手术前一周内，术后1、6个月采用SF-36量表测评患者的生存质量。根据患者是否存在抑郁症将患者分为抑郁组和非抑郁组，对比分析两组间术前、术后的生存质量状况。结果术前抑郁症患者59例（42．7％），其中中度22例（15．9％），重度7例（5．1％）；术后呈逐渐下降趋势；SF-36量表的生理健康内容和心理健康内容在术后均有不同程度改善；比较术后生存质量评分发现抑郁组社会功能、情感职能、精神健康和躯体疼痛分项评分显著低于非抑郁组，其他分项和总评分差异无统计学意义，但平均值均低于非抑郁组。结论行CABG的患者共病抑郁者在术后生存质量改善上明显低于无共病抑郁的患者，尤其是社会功能、情感职能、精神健康和躯体疼痛方面，需要引起重视。Objective To investigate the presence and severity of depression before and after operation in patients undergoing coronary artery bypass grafting （CABG） and the effect thereof on the quality of life. Methods A validated Chinese version of Beck Depression Inventory （BDI） was used in 138 CABG patients that were divided into 2 groups according the fact if depression was present. 1 week before and 1,3, and 6 months after operation, and SF-36 scale was used to evaluate the quality of life （QOL） one week before operation and l and 6 months after operation. Results Depressive disorders occurred in 42.7% of the patients preoperatively and in 23. 1% of the patients 6 months after the operation . There were no significant differences in all the dimensions of the SF-36 scale before operation between the depression and non-depression groups. All the scores of the 36-F dimensions were improved 1 and 6 months after the operation. However, the SF-36 social functioning （SF）, mental health （MH）, role emotional （RE）, and bodily pain （BP） subscale scores 6 months after operation of the depression group were all lower than those in the non-depressive groups （all P 〈 0.05）. Conclusion Depression symptoms at different degrees exist before CABG and can be improved post-operatively. The improvement of QOL of the depressive patients after operation is not so marked compared to the non-depressive patients, especially in SF, MH, RE, and BP dimensions.

关 键 词：冠状动脉旁路移植术 非体外循环 抑郁症 患者 临床治疗 

分 类 号：R686[医药卫生—骨科学]