失眠认知行为治疗联合常规护理在酒精戒断综合征患者中的应用  

Application of cognitive behavioral therapy for insomnia combined with routine nursing in patients with alcohol withdrawal syndrome

作　　者：沈萧纯 杜哲一[1] SHEN Xiaochun;DU Zheyi(Department of Substance Dependence and Addiction,Mental Health Center Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 201108,China)

机构地区：[1]上海交通大学医学院附属精神卫生中心物质依赖与成瘾科,上海201108

出　　处：《临床与病理杂志》2023年第2期372-378,共7页Journal of Clinical and Pathological Research

摘　　要：目的:探讨失眠认知行为治疗(cognitive behavioral therapy for insomnia,CBTI)联合常规护理对酒精戒断综合征(alcohol withdrawal syndrome,AWS)患者的效果。方法:选取2020年6月至2022年1月在上海交通大学医学院附属精神卫生中心接受治疗的121例AWS患者,采用随机数表法分为观察组(60例)和对照组(61例)。对照组实施常规干预,观察组在其基础上联合CBTI干预。对比干预前后酒精使用障碍筛查量表(Alcohol Use Disorders Identification Test,AUDIT)、匹兹堡睡眠质量指数(Pittsburgh Sleep Quality Index,PSQI)、蒙特利尔认知评估量表(Montreal Cognitive Assessment,MoCA)、一般自我效能感量表(General Self-Efficacy Scale,GSES)评分,同时记录2组患者并发症发生情况以及干预后3、6个月内的复饮情况。结果:观察组干预后4、8、14 d的AUDIT评分均低于对照组(均P<0.05)。干预后2周,观察组患者的PSQI评分低于对照组(P<0.05),入睡时间短于对照组(P<0.05),MoCA、GSES评分高于对照组(P<0.05)。2组干预后3个月复饮率差异无统计学意义(P>0.05),观察组干预后6个月复饮率低于对照组(P<0.05)。结论:CBTI联合常规护理可有效帮助AWS患者降低酒精依赖,改善患者的睡眠质量、自我意识。Objective:To explore the effect of cognitive behavioral therapy for insomnia(CBTI)combined with routine nursing on patients with alcohol withdrawal syndrome(AWS).Methods:A total of 121 AWS patients who were treated in Mental Health Center Affiliated to Shanghai Jiao Tong University School of Medicine from June 2020 to January 2022 were selected and divided into 2 groups:an observation group(60 cases)and a control group(61 cases)by random number table method.The control group was given routine intervention,and the observation group was combined with CBTI intervention on this basis.The scores of Alcohol Use Disorder Screening Inventory(AUDIT),Pittsburgh Sleep Quality Index(PSQI),Montreal Cognitive Assessment Scale(MoCA),and General Self Efficacy Scale(GSES)were compared before and after the intervention.At the same time,the incidence of complications and the resumption of drinking 3 and 6 months after intervention were compared between the 2 groups.Results:The AUDIT scores of the observation group on the 4th,8th,and 14th day after the intervention were lower than those of the control group(all P<0.05).Two weeks after the intervention,the PSQI score of the observation group was lower than that of the control group(P<0.05),the time to fall asleep was shorter than that of the control group(P<0.05),and the MoCA and GSES scores were higher than those of the control group(both P<0.05).There was no difference in the rate of re-drinking in the two groups at 3 months after intervention(P>0.05),and the rate of re-drinking in the observation group was lower than that in the control group at 6 months after intervention(P<0.05).Conclusion:CBTI combined with routine care can effectively help AWS patients reduce alcohol dependence and improve their sleep quality and self-awareness.

关 键 词：酒精戒断综合征 失眠认知行为治疗 酒精依赖严重程度 复饮率 

分 类 号：R473.74[医药卫生—护理学]