【作者】 古丽扎尔·买买提明；

【导师】 张爱伦；

【作者基本信息】 新疆医科大学 ， 老年医学， 2006， 硕士

【摘要】 目的：了解老年冠心病患者心脏介入(PCI)治疗前后的情绪障碍和心理干预效果。方法：收集2005年11月～2006年9月在我院住院年龄≥60岁的行PCI术的冠心病患者62例。冠心病诊断符合1979年WHO冠心病诊断标准。随机分为对照组和心理干预组，对所有入选患者均按冠心病常规治疗。对干预组患者在PCI手术前后给予综合心理治疗，包括社会和家庭的支持性心理治疗，个别心理治疗及患者间互相治疗。并进行两组间一般情况比较；手术前后两组临床表现的变化分析，以及干预组和对照组在手术前后不同时间点心率和血压变化比较；对所有入选病人焦虑、抑郁状况采用焦虑、抑郁自评量表进行了问卷调查。抑郁焦虑诊断均符合中国神经疾病分类方案与诊断标准。结果：干预组和对照组患者年龄、性别的构成比以及合并其他心血管疾病之间差异无统计学意义(P＞0.05)；干预组和对照组在术前失眠、胸闷、纳差等临床表现比较基本无差异，但经干预治疗后，干预组的上述临床明显少于对照组(P＜0.05)；术前两组心率及收缩压有上升趋势，但经心理干预治疗后干预组心率及收缩压上升幅度明显低于对照组(P＜0.01)；两组患者在干预前SAS和SDS的症状评分均无显著性差异(P＞0.05)，而心理干预后，干预组的情绪障碍(SAS 28.09±5.12，SDS 26.35±4.91)较对照组(SAS 37.60±5.53，SDS 34.62±5.72)明显改善(P＜0.05)，而减分率显著增高(P＜0.01)。结论：综合心理干预可以有效地减轻老年冠心病患者接受PCI治疗时的焦虑抑郁障碍。更多还原

【Abstract】 Objection: To study emotional disorder in senile patients with coronary heart disease(CHD) before and after percutaneous coronary intervention (PCI) and to investigate the effect of psychotherapy.Methods: Sixty-two senile patients with CHD (age≥60Y) from November, 2005 to September 2006 in our department were divided with randomized principle into two groups. Psychotherapy group (n=32) and control group (n=30). The patients in psychotherapy group were given combined therapy, included psychological surportive treatment from society and family, individual psychological treatment and treatment between patients. The general state, clinical manifestation as well as changes of heart rate and blood pressure in two groups were compared. The state of anxiety and depression in all patients were analyzed according to psychological test scale.Results: The difference of constituent ratio of age, sex, combined other cardiovascular disease and clinical manifestation in two groups were not statistically significant (p>0.05). Ascensus of heart rate and systolic blood pressure with psychotherapy group were lower significantly than those of control group(p<0.01 = . Emotion disorder with psychotherapy group (SAS 28.09 ± 5.12, SDS 26.35 ± 4.91) was improved significantly compared with that of control group (SAS 37.60±5.53, SDS 34.62 ± 5.72)(P<0.05)Conclusion: Psychotherapy intervention is an effective method to更多还原