心理行为干预结合生物反馈训练对冠状动脉搭桥术后患者情绪状态及生活质量的影响研究  

Effects of psychological and behavioral intervention combined with biofeedback training on emotional status and quality of life of patients after coronary artery bypass grafting

作　　者：周立芹[1] 高春枝[1] 刘玉珍[1] 王霞 张玉梅 刘霁红 Zhou Liqin;Gao Chunzhi;Liu Yuzhen;Wang Xia;Zhang Yumei;Liu Jihong(Tangshan City Workers Hospital,Tangshan,Hebei 06300)

机构地区：[1]河北省唐山市唐山工人医院,河北唐山063000

出　　处：《护士进修杂志》2018年第23期2117-2120,2129,共5页Journal of Nurses Training

基　　金：河北省医学科学研究重点课题计划项目(编号:20181261)

摘　　要：目的探讨心理行为干预结合生物反馈训练对冠脉搭桥术后患者情绪状态、生活质量的影响。方法采用便利抽样法选择2016年4月-2017年4月收治的冠脉搭桥术后患者96例为研究对象,用随机数字表法分为观察组和对照组各48例。对照组给予包括健康教育、康复训练、用药指导、并发症预防等在内的常规护理干预,观察组联合应用心理行为干预结合生物反馈训练。比较两组患者负性情绪、心率变异性、肺功能等指标。结果干预前后观察组焦虑自评量表(SAS)、抑郁自评量表(SDS)评分低于对照组(t=4. 104,3. 013,P<0. 05);随访3个月时,观察组正常R-R间期标准差(SDNN)、全程5min段R-R间期标准差(SDANN)、全程5 min段N-N间期标准差(SDNN index)、全程相邻R-R间期差值均方根值(r MSSD)等高于对照组(t=5. 515,3. 776,2. 955,4. 500,P<0. 05),左心室射血分数(LVEF)、用力肺活量(FVC)明显高于对照组(t=2. 021和3. 141,P<0. 05),差异均有统计学意义。结论心理行为干预联合生物反馈训练有助于缓解冠脉搭桥术患者焦虑、抑郁情绪,调节心率变异性,改善肺功能。Objective To explore the effect of psychological behavior intervention combined with biofeedback training on emotional state and quality of life of patients after coronary artery bypass grafting Methods 96 patients after coronary artery bypass grafting from April 2016 to April 2017 were selected as the study subjects,which were divided into observation group（ n = 48） and control group（ n = 48） by the random number table. The control group was given routine nursing intervention,including health education,rehabilitation training,medication guidance,prevention of complications,while the observation group was given psychological behavioral interventions combined with biofeedback training. The negative emotion,heart rate variability and lung function were compared between the two groups. Results Self-rating anxiety scale（ SAS） and Self-rating depression scale（ SDS） scores in observation group were significantly lower than those in control group（ t = 4.104,3.013,P〈0.05）. At 3 months of follow-up,the standard diviation of RR intervals（ SDNN）,standard deviation of the averages of RR internals in all 5 minute segments（ SDANN）,the mean of standard deviations of RR intervals for all 5-min segments of 24-hour ECG recordings（ SDNN index）,The root mean square successive difference（ RMSSD）was significantly higher than that of the control group（ t = 5.515,3.776,2.955,4.500,P〈0.05）. Left ventricular ejection fraction（ LVEF） and forced vital capacity（ FVC） were significantly higher than those in the control group（ t = 2.021,3.141,P〈0.05）. Conclusion Psychological behavioral interventions combined with biofeedback training can help resolve anxiety and depression,improve heart rate variability and improve lung function in patients undergoing coronary artery bypass grafting.

关 键 词：冠脉搭桥术 心理行为干预 生物反馈训练 负性情绪 心率变异性 护理 

分 类 号：R473.54[医药卫生—护理学] R541.4[医药卫生—临床医学]