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目的:通过对急性心肌梗死(AMI)伴有焦虑情绪的患者行心理干预,观察其焦虑情绪、躯体症状、心律失常、心功能变化、病死率及住院天数的改变,探讨心理干预在救治AMI中的临床意义及可行性操作方法。方法:将近3年来共收治的160例伴有情绪障碍的AMI患者,随机分成干预组(80例)和对照组(80例),对照组给予常规药物治疗,干预组则在常规药物治疗的基础上进行健康教育和心理干预,焦虑情绪严重者服用苯二氮类药物或三环类抗抑郁药治疗,1个月后行Zung焦虑自评量表(SAS)、汉密顿焦虑量表(HMAS)评估,并对躯体症状、心律失常、心功能、病死率、住院天数进行分析评价。结果:1个月后,干预组SAS评分、HMAS显著低于对照组(P<0.01);干预组与对照组相比,躯体症状明显缓解(P<0.05);心律失常、病死率、平均住院天数显著减少(P<0.01);心功能明显好转(P<0.05)。结论:AMI常伴有情绪障碍,尤其是焦虑。及时、科学、合理的心理干预不仅可改善AMI患者的情绪障碍,而且还可使患者的躯体症状明显缓解,使心律失常、心力衰竭、病死率、住院天数明显减少。
OBJECTIVE: To observe the changes of anxiety, somatic symptoms, arrhythmia, cardiac function, mortality and hospitalization days in patients with acute myocardial infarction (AMI) accompanied by anxiety. To explore the psychological intervention in AMI The clinical significance and feasibility of operation. Methods: A total of 160 AMI patients with mood disorders who were treated in the recent 3 years were randomly divided into intervention group (n = 80) and control group (n = 80). The control group was given conventional drug treatment. The intervention group was on the basis of conventional drug treatment On the health education and psychological intervention, anxiety and severe taking benzodiazepines or tricyclic antidepressants treatment, 1 month after the Zung self-rating anxiety scale (SAS), Hamilton Anxiety Scale ( HMAS) assessment, and physical symptoms, arrhythmia, cardiac function, mortality, hospitalization days were analyzed. Results: At 1 month, SAS scores and HMAS in the intervention group were significantly lower than those in the control group (P <0.01); somatic symptoms were significantly relieved in the intervention group compared with the control group (P <0.05); arrhythmia, mortality, The number of days was significantly decreased (P <0.01); heart function improved significantly (P <0.05). Conclusion: AMI is often associated with mood disorders, especially anxiety. Timely, scientific and reasonable psychological intervention can not only improve the mood disorder of patients with AMI, but also make patients relieve somatic symptoms, so that arrhythmia, heart failure, mortality, hospitalization days was significantly reduced.