心脏起搏患者术前心理状况及其心理干预的作用  

Investigation of Psychology State in Cardiac-Pacing Patients and Effects of Psychotherapy

作　　者：杨海涛[1] 祁述善[1] 沈向前[1] 金淑莲[1] 李思特[2] 

机构地区：[1]中南大学湘雅二院心内科 [2]中南大学湘雅二院精神科

出　　处：《中国心脏起搏与心电生理杂志》2003年第3期189-191,共3页Chinese Journal of Cardiac Pacing and Electrophysiology

摘　　要：为了解心脏起搏患者术前的心理状态及心理干预的作用 ,采用症状自评量表 (SCL 90 )调查 86例心脏起搏患者 ,总分 >16 0分或单个因子分 >2分示有心理问题。用焦虑自评量表 (SAS) ,抑郁自评量表 (SDS)分别评价 86例心脏起搏患者心理干预前后的焦虑、抑郁得分变化及其与 39例对照组的差别。结果 :SCL 90调查显示 :86例心脏起搏患者存在以焦虑 (4 3人 )、躯体化 (36人 )、恐怖 (34人 )、抑郁 (2 5人 )、人际关系 (2 2人 )为主要表现的心理问题 ,其得分均高于国内常模 (分别为 2 .0 9± 0 .5 9vs1.39± 0 .4 3,2 .19± 0 .5 4vs 1.37± 0 .4 8,2 .2 0± 0 .6 1vs1.2 3± 0 .4 1,2 .0 2± 0 .6 2vs 1.5 0± 0 .5 9,P均 <0 .0 1;2 .12± 0 .4 8vs 1.6 5± 0 .5 1,P <0 .0 5 )。心理干预后患者焦虑、抑郁得分明显下降 ,与干预前相比有统计学显著性差异 (分别为 4 1.2 4± 7.2 6vs 4 6 .78± 9.2 5 ,38.6 9± 6 .14vs4 4 .5 6± 7.82 ,P均 <0 .0 1) ;而对照组焦虑、抑郁两次评分比较无统计学显著性差异。结论 :心脏起搏患者存在焦虑、躯体化、恐怖、抑郁、人际关系等明显心理问题 ,心理干预能明显缓解患者的焦虑、抑郁状况。To investigate the psychology state and the effects of psychotherapy,125 patients were divided into two groups at random,86 patients received psychotherapy,and the others were controlled.Symptom Checklist 90(SCL-90)was used for evaluating the patients' psychology state.The total factors score >160 or the single factor score >2 suggested the patient had psychological problems.SAS (Self-Rating Anxiety Scale) and SDS(Self-Rating Depression Scale)were used for rating the patients and the control before and after psychotherapy.The scores of anxiety and depression were compared respectively before and after psychotherapy,as well as with those of the control.Results:The SCL-90 showed the 86 cardiac-pacing patients had serious psychologicalproblems infive factors:anxiety(43 patients), somatization(36 patients), phobic anxiety(34 patients),depression(25 patients),interpersonal sensitivity(22 patients)and so on.All of the factors scores were respectively higher than those of the normal as following:2.09±0.59 vs 1.39±0.43, 2.19±0.54 vs 1.37±0.48,2.20±0.61 vs 1.23±0.41,2.02±0.62 vs 1.50±0.59, 2.12±0.48 vs 1.65±0.51, P<0.01 or 0.05 .Both of the anxiety score and depression score decreased markedly after psychotherapy(41.24±7.26 vs 46.78±9.25,38.69±6.14 vs 44.56±7.82,all P<0.01 ).There were no statistically obvious changes in the control before the cardiac-pacing procedure.Conclusion:Cardiac-pacing patients have obvious psychological problems in anxiety, somatization,phobic anxiety,depression and interpersonal sensitivity.

关 键 词：心脏起博 术前 心理状况 心理干预 症状自评量表 焦虑 抑郁 

分 类 号：R318.11[医药卫生—生物医学工程] R749.055[医药卫生—基础医学]