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

邱原刚; 张芙荣; 陈君柱; 朱建华; 陶谦民; 郑良荣; 许毅; 赵莉莉

Abstract

邱原刚,张芙荣,陈君柱,朱建华,陶谦民,郑良荣,许毅,赵莉莉.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[J].Chinese journal of Epidemiology,2003,24(10):928-931

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 inf luencing factors on patients undergoing electrophysiology studies andradiofrequency catheter ablation

Received:February 10, 2003

DOI：

KeyWord: 心理健康症状自评量表电生理技术,心脏导管消融术心动过速,室上性

English Key Word: Mental health Symptom Check List-90 Electrophysiologic techniques, cardiac Catheter abla tio n Tachycardia, supraventricular

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

Author Name	Affiliation
QIU Yuan-gang	Department of Cardiology, First A ff iliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China
ZHANG Fu-rong	Department of Cardiology, First A ff iliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China
CHEN Jun-zhu	Department of Cardiology, First A ff iliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China
ZHU Jian-hua	Department of Cardiology, First A ff iliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China
TAO Qian-min	Department of Cardiology, First A ff iliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China
ZHENG Liang-rong	Department of Cardiology, First A ff iliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China
XU Yi	浙江大学医学院附属第一医院精神卫生科
ZHAO Li-Li	Department of Cardiology, First A ff iliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China

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Abstract:

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125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(SCL90)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;术前向患者详细介绍手术过程及并发症的情况不会引起患者过度的心理负担

English Abstract:

Objective　To study the psychological status and its influencing factors in patients before and after electrophysiology studies and radiofrequency catheter ablation (RFCA).Methods　125 inpatients (71 men, 54 women, mean age 42.91 years ±16.1 years)who underwent a scheduled electrophysiology studies and RFCA for the first time and fulfilled entry criteria, were enrolled.They were randomly assigned to receiving either a consent which did not detail specific risk (group B)regarding the procedure o r one that detailed the risks (group A).All patients were examined by the Chinese version of Symptom Check List-90 (SCL-90)within 24 hours before the procedure (af ter the co nsent)and o n the third day after.Results(1)Before the electrophysiology studies and RFCA, sco res of anx iety and phobic anxiety constructs were hig her than the norm.After the procedure, no specific construct sco re became higher.(2)After the procedure, patients showed a significantly decrease in the scores of obsessive-compulsive, depression, anxiety,hostility, phobic anxiety, paranoid ideation, psycho tism constructs, global severity index, total positive symptoms and po sitive symptom severity index.(3)Women sco red higher on somatization, depressio n,anxiety, phobic anxiety co nstructs, global severity index and positive symptom to tal before the procedure.(4)Detail informed consent was not asso ciated with increased mental symptoms when compared with consent that did not detail specific risks.Conclusions In this study, patients showed slig htly anxiety and phobic anxiety befo re electrophysiology studies and RFCA with women having mo re mental symptoms befo re the procedure that called for special attention.Detail information including the course and specific risk reg arding the procedure was no t associated with increased psycholog ical symptoms.It was suggested that the patients should receive detail information before electrophysiology studies and RFCA.

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