急性左心衰患者的情感与疾病的转归  

Relation between emotion and therapeutic effect in patients with acute left heart failure

作　　者：黎惠芬 余同珍[2] 杨淑群[1] 

机构地区：[1]广州市白云区人民医院,广东广州510500 [2]广东省人民医院广东省心血管研究所

出　　处：《心血管康复医学杂志》2011年第2期171-174,共4页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:探讨急性左心衰患者的情感与疾病转归的关系,为临床提供情感护理依据。方法:对2010年1月至2010年6月入住我科的18例急性左心衰患者进行正性情感护理,包括情感的心理疏导及情感支持。在病情稳定4h及出院前用抑郁自评量表和焦虑自评量表进行问卷调查。于发病或接诊后1h内记录呼吸、心率、血压,观察治疗前、后血气变化。结果:在患者躁动与呼吸机不同步时,实施护理措施,7min内患者情绪基本稳定,能与呼吸机同步。与治疗前比较,治疗后呼吸[(30±5.0)次/min∶(23±3.1)次/min]、心率[(120±30)次/min∶(90±25)次/min]显著下降(P均<0.01),氧分压[(8.80±1.18)kPa∶(13.6±1.02)kPa]、血氧饱和度[(78.8±4.50)%∶(98.04±1.49)%]明显提高(P<0.05),焦虑与抑郁评分明显好转(x2分别为9.124,9.242,P均<0.01),心功能显著好转,NYHAⅣ级患者显著减少[(100%∶11.1%),P<0.01]。病情基本控制时间为1d。结论:注重患者的情感变化,采取相应的护理措施配合医疗,能有效促进急性左心衰好转。Objective： To explore the relation between emotion and therapeutic effect of disease in patients with acute left heart failure and provide basis for emotional nursing cares.Methods： A total of 18 patients with acute left heart failure admitted from January 2010 to June 2010 received positive emotional nursing care contained： psychological persuasion and affection support.Questionnaire survey was performed after patient′s condition stable for 4h and prior to discharge with self-rating depression scale and anxiety scale.The breath,heart rate and blood pressure were recorded within 1h after attack or visit and change of blood gas were observed.Results： When patients restlessness and not synchronized with respirator,nursing cares were performed and their emotion turned stable within 7min and became synchronized with respirator.Compared with before treatment,after therapy the breath [（30±5.0） times/min vs.（23±3.1） times/min]、heart rate [（120±30） times /min vs.（90±25） times /min] significantly decreased（P0.01 both）,partial pressure of oxygen [（8.80±1.18） kPa vs.（13.6±1.02） kPa]、blood oxygen saturation [（78.8±4.50）% vs.（98.04±1.49）%] significantly increased（P0.05 both）,anxiety and depression scores significantly improved（x2=9.124,9.242,P0.01 both）.Heart function significantly improved,patients with NYHA class Ⅳ significantly decreased[（100% vs.11.1%）P0.01].Mean time for control of patients＇ condition was 1d.Conclusion： More attention on emotional changes of patients,corresponding nursing cares matched with medical treatment could effectively improve therapeutic effect of acute left heart failure.

关 键 词：心室功能障碍 左 护理 焦虑 抑郁 

分 类 号：R541.6[医药卫生—心血管疾病]