“双心医学”模式在经皮冠状动脉介入治疗术后伴抑郁患者护理中的应用分析  

Analysis of psycho-cardiology medicine model in nursing care of coronary heart disease patients with depressive symptoms after percutaneous coronary intervention

作　　者：刘媛媛 段咏梅[3] 卡丽毕努尔·力提甫[4] 杨益[4] LIU Yuanyuan;DUAN Yongmei;Kalibinuer Litifu;YANG Yi(College of Nursing,Xinjiang Medical University,Urumqi 830011,China;The First Department of the Secondary Supply Room of the Disinfection Distribution Center,Xinjiang Medical University,Urumqi 830054,China;The Second Department of Coronary Heart Disease,Xinjiang Medical University,Urumqi 830054,China;Department of Nursing,the First Affiliated Hospital,Xinjiang Medical University,Urumqi 830054,China)

机构地区：[1]新疆医科大学护理学院,乌鲁木齐830011 [2]新疆医科大学第一附属医院消毒配送中心次供应室一部,乌鲁木齐830054 [3]新疆医科大学第一附属医院心脏中心冠心病二科,乌鲁木齐830054 [4]新疆医科大学第一附属医院护理部,乌鲁木齐830054

出　　处：《新疆医科大学学报》2020年第7期985-988,992,共5页Journal of Xinjiang Medical University

基　　金：新疆维吾尔自治区卫生计生委青年科技医学人才青科项目(WJWY-201835)。

摘　　要：目的探讨“双心医学”模式在经皮冠状动脉介入治疗术后伴抑郁患者中的应用效果。方法选取2019年1-10月在某三级甲等综合医院住院已行PCI术后的CHD患者579例,将汉密尔顿抑郁量表≥8分的患者110例纳入抑郁组,其余纳入非抑郁组(469例);其中抑郁组随机分为干预组和对照组,各55例。对照组给予常规护理及心理健康教育指导,干预组在常规护理的基础上给予双心照护,比较两组患者汉密尔顿抑郁量表评分差异。结果抑郁组与非抑郁组比较,既往心肌梗死病史是冠心病患者PCI术后发生抑郁情绪的独立危险因素(P=0.009)。进行双心护理干预4个月后,干预组HAMD总分干预后较干预前明显下降,差异有统计学意义(P=0.000)。干预后,干预组HAMD总分明显低于对照组,差异有统计学意义(P=0.014)。进一步分层比较,既往心肌梗死阳性抑郁组患者双心照护后,HAMD总分明显下降,差异有统计学意义(P=0.002)。结论既往心肌梗死病史是经皮冠状动脉介入治疗术后发生抑郁的独立危险因素,积极地提供双心照护模式,有助于改善患者的抑郁情绪。Objective To explore the effect of the therapy of“psycho-cardiology medicine”on depression after percutaneous coronary stent implantation(PCI).Methods 579 patients after PCI were selected,110 patients with Hamilton Depression Scaled≥8 points were included in the depression group,and the rest were included in the non-depression group;the depression group was randomly divided into the intervention group and the control group,55 patients in the control group were given routine care,while 55 patients in the intervention group were given psycho-cardiology nursing careon the basis of routine care,and the scores of Hamilton Depression Table of the two groups were compared.Results Compared with the non-depression group,the history of myocardial infarction was an independent risk factor for patients after PCI with depression(P=0.009).After 4 months of psycho-cardiologynursing care,the total score of HAMD in the intervention group was decreased significantly(P=0.000).After intervention,the total score of HAMD in the intervention group was significantly lower than that in the control group(P=0.014).Further stratified comparison showed that the total score of HAMD in the patients with previous positive myocardial infarction depression group was decreased significantly(P=0.002).Conclusion The history of myocardial infarction is an independent risk factor for patients after PCI with depression.Psycho-cardiology care would be helpful to improve the depression of the patients.

关 键 词：冠心病 经皮冠状动脉介入治疗术后 抑郁 双心医学 

分 类 号：R541[医药卫生—心血管疾病]