心理护理与音乐疗法对难治性心力衰竭患者身心的影响  

Effects of psychological intervention and music therapy on mental disease and cardiac function in patient with refractory heart failure

作　　者：周静[1,2] 徐静[2] 唐碧[2] 王洪巨[2] 周倩[2] 徐凌忠[1] 

机构地区：[1]山东大学公共卫生学院,济南市250012 [2]安徽省蚌埠医学院第一附属医院心血管科,233004

出　　处：《中华全科医学》2015年第7期1185-1187,共3页Chinese Journal of General Practice

基　　金：蚌埠医学院院级课题(Byky1225)

摘　　要：目的 探讨心理护理与音乐疗法对难治性心力衰竭患者身心的影响。方法 应用焦虑自评量表、抑郁自评量表评价250例难治性心力衰竭患者,将其中209例并发焦虑（120例）、抑郁（89例）的患者随机分成对照组59例和干预组150例。对照组（A组）给予常规心血管药物治疗,干预组则在常规药物的基础上进行心理护理干预（B组,48例）、音乐疗法（C组,50例）、心理护理联合音乐疗法（D组,52例）,焦虑或抑郁情绪严重者服用适量抗焦虑抑郁药物,疗程1个月,治疗前后应用SAS、SDS进行评估,应用超声心动图对患者的左心室射血分数进行评价,并应用双夹心抗体法测定治疗前后各组患者血浆脑型利钠肽（BNP）浓度的变化。结果 与普通人群相比,难治性心力衰竭患者抑郁、焦虑情绪发生率明显升高（35.6%vs.5%~10%,57.4%vs.5%）。与A组比较,B组、C组及D组SDS及SAS评分显著降低,血浆BNP的降低幅度及左心室射血分数明显增加,差异具有统计学意义;与B组和C组比较,D组患者的SDS及SAS评分显著降低,血浆BNP的降低幅度及左心室射血分数明显增加,差异具有统计学意义;B组和C组比较差异无统计学意义。结论 医院难治性心力衰竭患者抑郁、焦虑情绪发生率较高;在常规药物基础上,联合应用心理护理与音乐疗法能有效改善难治性心力衰竭患者的焦虑、抑郁情绪,改善心脏功能。Objective To study the occurrence of anxiety and depression and explore the effects of psychological interven- tion and music therapy combination on mental disease and cardiac function in patients with refractory heart failure （RHF）. Methods A total of 250 refractory heart failure patients were recruited. They were assessed with the self-rating anxiety scale（SAS） and the self-rating depression scale （SDS）, and then 209 patients with anxiety or depression were se- lected. All subjects were divided into two groups（ 150 in observation group and 59 in control group） randomly. The control group （A group） only received conventional cardiovascular drugs therapy, while the observation group received psychologi- cal intervention, music therapy or both beside received conventional cardiovascular drugs therapy lasting four weeks. The observation groups were included psychological intervention group （ B group, n = 48 ）, music therapy group （ C group, n =- 50） and combination intervention group（D group,n =52）. Then the changes of SAS score and SDS score and cardiac function in two groups after intervention were observed. The serum levels of brain natriuretic peptide（BNP） were meas- ured by ELISA,meanwhile left atrium diameters（LAD） were determined by echocardiography. Results The occurrence of depression and anxiety of refractory heart failure patients in our hospital were higher than that of the general population （35.6% vs. 5% -10% ,57.4% vs. 5% ,respectively）. Compared to A groups,the SDS score and SAS score were re- duced in B, C and D groups ; the reduced degree of the serum levels of BNP and the increased degree of the LVEF in case group were higher than those in A group, and there was significant difference between the two groups. Compared with B group and C group, the SDS score and SAS score were significantly decreased in D group, moreover the reduced degree of the serum levels of BNP and the increased degree of the LVEF in case group were higher than those in B group and C

关 键 词：难治性心力衰竭 心理护理 音乐疗法 抑郁情绪 心脏功能 

分 类 号：R473.54[医药卫生—护理学] R514.6[医药卫生—临床医学]