强化心理应激对增殖性糖尿病视网膜病变患者术后应激的影响  

Effect of intensive psychological stress on postoperative stress in patients with proliferative diabetic retinopathy

作　　者：盛群芳 殷雪[1] 李弢[1] SHENG Qunfang;YIN Xue;LI Tao(Department of Ophthalmology,The First Affiliated Hospital of Suzhou University,Suzhou 215006,China)

机构地区：[1]苏州大学附属第一医院眼科,215006

出　　处：《中国健康心理学杂志》2022年第10期1505-1510,共6页China Journal of Health Psychology

基　　金：江苏省自然科学基金项目(编号:BK20210095)。

摘　　要：目的:研究强化心理应激干预对增殖性糖尿病视网膜病变(PDR)患者术后应激反应及心理状况的影响。方法:选取108例拟行玻璃体切除术的PDR患者为研究对象,采用随机数字表法将其分为对照组(n=54)及观察组(n=54),对照组给与常规护理干预,观察组给与强化心理应激干预。术后6个月,比较两组患者手术效果、心理状态、氧化应激指标、生活质量及遵医行为。结果:术后6个月,视力方面,观察组患者显著高于对照组(t=2.561,P<0.05);焦虑自评量表(SAS)、抑郁自评量表(SDS)评分,观察组显著低于对照组(t=2.757,3.874;P<0.05);血清超氧化物歧化酶(SOD)及总抗氧化能力(TAC)水平,观察组显著高于对照组(t=2.059,4.304;P<0.05),血清丙二醛(MDA)水平,观察组显著低于对照组(t=5.059,P<0.05);低视力者生活质量量表(LVQOL)内的中远视力、阅读及精细动作、调节能力与日常生活能力评分,观察组显著高于对照组(t=2.976,5.202,5.645,4.169;P<0.05);遵医用药、饮食、运动、自我检测、定期复查患者占比,观察组显著高于对照组(χ^(2)=8.447,4.000,4.610,4.696,6.943;P<0.05)。结论:围手术期实施强化心理应激干预措施有利于改善PDR患者术后负性心境状态及氧化应激指标水平,提高患者视力水平及生活质量,促进其遵医行为。Objective:To investigate the effect of intensive psychological intervention on stress response and psy-chological status of patients with proliferative diabetic retinopathy after operation.Methods:One hundred and eight patients with PDR who planned to undergo vitrectomy were randomly divided into control group(n=54)and obser-vation group(n=54).The control group was given routine nursing intervention and the observation group was given intensive psychological stress intervention.Six months after operation,the operation effect,psychological state,oxida-tive stress index,quality of life and medical compliance behavior of two groups were compared.Results:Six months after operation,the visual acuity in the observation group was significantly higher than that in the control group(t=2.561,P<0.05);The scores of self-rating Anxiety Scale(SAS)and self-rating Depression Scale(SDS)in the ob-servation group were significantly lower than those in the control group(t=2.757,3.874;P<0.05);The levels of se-rum superoxide dismutase(SOD)and total antioxidant capacity(TAC)in the observation group were significantly higher than those in the control group(t=2.059,4.304;P<0.05),and the levels of serum malondialdehyde(MDA)in the observation group were significantly lower than those in the control group(t=5.059,P<0.05);The scores of middle and far vision,reading,fine movement,adjustment ability and daily living ability in the LVQOL were signifi-cantly higher in the observation group than those in the control group(t=2.976,5.202,5.645,4.169;P<0.05);The proportion of patients in the observation group was significantly higher than that in the control group(χ^(2)=8.447,4.000,4.610,4.696,6.943;P<0.05).Conclusion:The perioperative implementation of intensive psychological stress intervention measures is conducive to improve the postoperative negative mood state and oxidative stress index level of PDR patients,improve the visual acuity level and quality of life of patients,and promote their compliance behavior.

关 键 词：强化心理应激干预 增殖性糖尿病视网膜病变 应激反应 心理状况 遵医行为 生活质量 

分 类 号：R749.92[医药卫生—神经病学与精神病学]