心内电生理检查及射频消融术前后患者心理状况及影响因素分析  

Psychological status and its influencing factors on patients undergoing elect rophysiology studies and radiofrequency catheter ablation

作　　者：邱原刚[1] 张芙荣[1] 陈君柱[1] 朱建华[1] 陶谦民[1] 郑良荣[1] 许毅[2] 赵莉莉[1] 

机构地区：[1]浙江大学医学院附属第一医院心内科,杭州310003 [2]浙江大学医学院附属第一医院精神卫生科,杭州310003

出　　处：《中华流行病学杂志》2003年第10期928-931,共4页Chinese Journal of Epidemiology

基　　金：浙江省教育厅科学研究基金资助项目 ( 2 0 0 2 0 82 5)

摘　　要：目的　了解心内电生理检查及射频消融手术前后患者的心理状况及影响因素。方法12 5例因阵发性室上性心动过速住院拟行首次电生理检查及射频消融手术的患者 ,随机进入术前详细谈话组及一般谈话组 ,手术前后分别用中国版 90项症状自评量表 (SCL 90 )评价。结果　 ( 1)术前焦虑和恐惧等因子分高于常模 ,术后各因子分恢复甚至低于常模水平 ;( 2 )手术后强迫症状、人际关系敏感、抑郁、焦虑、敌对、恐惧、偏执、精神病性等因子分、总均分、阳性项目数及阳性症状均分均较术前减低 ;( 3 )女性患者术前躯体化、抑郁、焦虑、恐惧等因子分、总均分及阳性项目数均高于男性 ;( 4 )详细谈话组手术前各因子得分与一般谈话组相比无差异。结论　电生理检查及射频消融手术前患者存在焦虑、恐惧等症状 ,女性患者术前有更多的心理症状 ,应得到更多的心理支持 ;Objective To study the psychological stat us and its influencing factors in patients before and after electrophysiology stud ies and radiofrequency catheter ablation (RFCA).Methods 125 inpatients (71 men,54 women,mean age 42.91 ye ars±16.1 years) who underwent a scheduled electrophysiology studies and RFC A for the first time and fulfilled entry criteria, were enrolled.They were rand omly assigned to receiving either a consent which did not detail specific risk (group B) regarding the procedure or one that detailed the risks (group A).All patients were examined by the Chinese version of Symptom Check List-90 (SCL-9 0) within 24 hours before the procedure (after the consent) and on the third day after. Results (1) Before the electrophysiology studies and R FCA,scores of anxiety and phobic anxiety constructs were higher than the norm.A fter the procedure,no specific construct score became higher.(2) After the proce dure,patients showed a significantly decrease in the scores of obsessive-compu lsive,depression,anxiety,hostility,phobic anxiety,paranoid ideation,psychotism c onstructs,global severity index,total positive symptoms and positive sympt om severity ind ex.(3) Women scored higher on somatization,depression,anxiety,phobic anxiety con structs,global severity index and positive symptom total before the procedure.(4 ) Detail informed consent was not associated with increased mental symptoms when compared with consent that did not detail specific risks. Conclusions In this study,patients showed slightly anxiet y and phobic anxiety before electrophysiology studies and RFCA with women having more mental symptoms before the procedure that called for special attenti on. Detail information including the course and specific risk regarding the proc edure was not associated with increased psychological symptoms.It was suggested that the patients should receive detail information before electrophysiology st udies and RFCA.

关 键 词：心内电生理检查 射频消融术 心理状况 影响因素 心理健康 心律失常 

分 类 号：R541.7[医药卫生—心血管疾病]