任毅 劉麗

[摘要] 目的 探討整合療法對(duì)冠脈介入治療患者焦慮狀態(tài)的影響。 方法 按照納入和排除標(biāo)準(zhǔn)選取2013年3月～2015年3月在我院接受冠脈介入治療的92例患者，將其分為觀察組與對(duì)照組，每組46例。所有患者均接受冠心病常規(guī)藥物和氟哌噻噸美利曲辛片（黛力新）治療，觀察組在常規(guī)藥物治療的基礎(chǔ)上給予整合療法進(jìn)行治療，3個(gè)月后觀察HAMA量表得分和胸部不適癥狀的改善情況，比較兩組干預(yù)效果。 結(jié)果 治療后，兩組的HAMA評(píng)分均低于治療前，觀察組下降更明顯（P<0.01），焦慮狀態(tài)和胸部不適癥狀的總改善率明顯優(yōu)于對(duì)照組（P<0.05）。 結(jié)論 應(yīng)用整合療法能夠改善患者的焦慮狀態(tài)，有效減輕胸痛、胸悶癥狀，提高患者的生活質(zhì)量。

[關(guān)鍵詞] 冠心病；冠狀動(dòng)脈介入術(shù)；焦慮；干預(yù)

[中圖分類(lèi)號(hào)] R473.5 [文獻(xiàn)標(biāo)識(shí)碼] B [文章編號(hào)] 1673-9701（2015）29-0073-03

Effect of integration therapy on the anxious state of patients received percutaneous coronary intervention

REN Yi1 LIU Li2

1.Department of Cardiology，the Third People's Hospital of Liaoyang City in Liaoning Province，Liaoyang 111000，China； 2.Basic Nursing Teaching and Research Section，Liaoyang Traditional Chinese Medicine School， Liaoyang 111000，China

[Abstract] Objective To investigate the effect of integration therapy on the anxious state of patients who received percutaneous coronary intervention. Methods According to the enrolling and removing standard， a total of 92 patients who received PCI were selected from March 2013 to March 2015 in our hospital，all of them were divided into observation group and control group. with 46 patients in each group. All patients received conventional drugs and deanxit treatment，the observation group received integration therapy on the basis of the conventional drugs，three months later，the scores of HAMA and the symptoms of chest discomfort were observed. Results After treatment，the HAMA scores of two groups were lower than before treatment，the observation group declined more significantly（P<0.01），the total improvement rate of anxious state and chest discomfort were obviously better than those of the control group（P<0.05）. Conclusion Integration therapy could improve the anxious symptoms of patients，relieve the symptom of thoracalgia，improve the quality of life.

[Key words] Coronary heart disease； Percutaneous coronary intervention； Anxiety； Intervene

冠心病（coronary heart disease，CHD）是一種嚴(yán)重危害人類(lèi)健康的常見(jiàn)疾病，是導(dǎo)致死亡的常見(jiàn)疾病之一，早發(fā)現(xiàn)、早治療可以明顯降低因冠心病導(dǎo)致心臟意外事件發(fā)生的危險(xiǎn)。在介入技術(shù)快速發(fā)展的今天，冠心病介入治療已經(jīng)與藥物治療、冠脈搭橋手術(shù)并列成為冠心病三大主要治療策略，冠脈介入治療患者因高額的醫(yī)療費(fèi)用、對(duì)預(yù)后的過(guò)度關(guān)注等因素導(dǎo)致術(shù)后出現(xiàn)不同程度的焦慮現(xiàn)象[1]。焦慮會(huì)影響患者的整個(gè)生活，最嚴(yán)重時(shí)可導(dǎo)致患者陷入死亡的恐懼中，這種焦慮、恐懼、抑郁等負(fù)面情緒嚴(yán)重影響治療的效果和預(yù)后。我院心內(nèi)科醫(yī)生采用整合療法干預(yù)冠脈介入術(shù)后的焦慮狀態(tài)，取得很好的療效，現(xiàn)報(bào)道如下。

1 對(duì)象與方法

1.1 研究對(duì)象

選擇2013年3月～2015年3月來(lái)我院心內(nèi)科住院接受冠狀動(dòng)脈介入治療的冠心病患者。納入和排除標(biāo)準(zhǔn)：自愿接受12周治療和隨訪的患者，手術(shù)指征參照2012年中國(guó)經(jīng)皮冠狀動(dòng)脈介入治療指南，術(shù)后1 d采用漢密爾頓焦慮量表（HAMA）進(jìn)行評(píng)分，選取HAMA≥14分的患者，排除嚴(yán)重的心、腦、肝、腎等器官功能衰竭者、正在服用抗抑郁藥物者、中途終止治療者、無(wú)故失訪者和不能準(zhǔn)確回答問(wèn)題完成調(diào)查者。依據(jù)干預(yù)方法將符合標(biāo)準(zhǔn)的92例患者分成觀察組和對(duì)照組：觀察組46例，男28例，女18例，平均年齡（58.7±13.4）歲，HAMA評(píng)分（24.02±3.94）分，HAMA≥14分者8例，21分≤HAMA≤28分者34例，HAMA≥29分者4例，單支血管病變者9例，雙支血管病變者33例，三支血管病變者4例；對(duì)照組46例，男30例，女16例，平均年齡（59.1±12.6）歲，HAMA評(píng)分（23.63±4.40）分，HAMA≥14分者11例，21分≤HAMA≤28分者30例，HAMA≥29分者5例，單支血管病變者11例，雙支血管病變者31例，三支血管病變者4例。兩組間性別、年齡、文化程度、合并高血壓、高脂血癥、糖尿病、常規(guī)用藥、吸煙史、冠狀動(dòng)脈病變程度、焦慮程度等比較差異無(wú)統(tǒng)計(jì)學(xué)意義（P>0.05），具有可比性。