经口内镜下食管肌层切开术(POEM)联合心理干预治疗贲门失弛缓症的体会  

Peroral endoscopic myotomy(POEM)with mental intervention in the treatment of achalasia

作　　者：张弘炎[1] 郭小丽[2] 关丽[3] 李锐 

机构地区：[1]新疆医科大学第一附属医院内镜中心,乌鲁木齐830054 [2]新疆医科大学第一附属医院干部外科,乌鲁木齐830054 [3]新疆医科大学第一附属医院消化内科,乌鲁木齐830054 [4]苏州医科大学附属第一医院消化内科,江苏苏州215006

出　　处：《新疆医科大学学报》2013年第12期1826-1828,共3页Journal of Xinjiang Medical University

基　　金：国家自然科学基金(81360082)

摘　　要：目的评估贲门失弛缓症(AC)患者行经口内镜下食管肌层切开术(peroral endoscopic myotomy,POEM)治疗的心理状态,探讨心理干预对其的影响。方法采用Zung氏焦虑自评量表(SAS)和抑郁自评量表(SDS)对50例行POEM手术AC患者的焦虑、抑郁情绪进行评估,针对患者心理问题的状态和原因分别实施有针对性的心理干预,并与正常人群进行比较。结果贲门失弛缓症患者组焦虑、抑郁得分均高于正常人群组(P<0.05),POEM手术后SAS和SDS得分均较术前明显下降(P<0.05),心理干预组患者较对照组分值更低(P<0.05)。结论贲门失弛缓症患者存在明显的焦虑、抑郁情绪,POEM手术能明显缓解贲门失弛缓症患者的焦虑、抑郁情绪,心理干预有助于进一步改善患者的焦虑、抑郁情绪。Objective To evaluate the treat mental state of achalasia of the cardia （AC） patients via oral en- doscopic myotomy （POEM）, and the impact of psychological intervention. Methods Fifty AC patients with POEM surgery were randomly divided into psychological intervention and control groups, and their anxiety and depression were assessed by Zung＇s Self-rating Anxiety Scale （SAS） and self-rating depression scale （SDS） ; the patients with psychological problems are the implementation of targeted psychological in tervention; then we compare the results with the normal group. Results The anxiety, depression scores of Achalasia patients were higher than the normal group （P 〈0.05） ; after POEM operation SAS and SDS scores were significantly decreased （P 〈0.05）; patients with psychological intervention were lower than that of the control group （P 〈0.05）. Conclusion Achalasia patients suffered from anxiety, depression,and POEM operation can alleviate the anxiety, depression of Cardia Achalasia patients, and psychological intervention is helpful to further cure the anxiety, depression of patients.

关 键 词：贲门失弛缓症 经口内镜下食管肌层切开术 心理干预 

分 类 号：R473.57[医药卫生—护理学]