冠状动脉旁路移植术后抑郁焦虑状态随访和分析

PSYCH OpenIR > 中国科学院心理研究所回溯数据库(1956-2010)

	冠状动脉旁路移植术后抑郁焦虑状态随访和分析
其他题名	Follow up and Analysis of Depression and Anxiety After Coronary Artery Bypass Grafting
	王忠杰
	2009-05-06
摘要	前瞻、对比研究冠状动脉旁路移植术（coronary artery bypass grafting，CABG）的患者术前、出院前和术后1年抑郁、焦虑状态的发生率、变化趋势以及随访术后1年内心血管事件的发生率。分析术前、出院前、术后1年抑郁焦虑状态的相关影响因素以及对术后1年内心血管事件的影响。本研究以北京大学第一医院心脏外科连续行择期CABG的患者为研究对象，在术前、出院前和术后1年使用ZUNG氏抑郁自评量表和焦虑自评量表进行抑郁、焦虑状态评分，同时随访术后1年内心血管事件的发生率。分别根据术前、出院前、术后一年是否存在抑郁焦虑状态进行分组，对比分析术前、出院前、术后一年抑郁焦虑状态的相关影响因素；以心血管事件为终点分析相关的影响因素。完成术前、出院前、以及术后1年随访调查的患者共有69例。术前24例（34.8%）存在抑郁焦虑状态，出院前31例(44.9%)存在抑郁焦虑状态，随访至术后1年10例（14.5%）存在抑郁焦虑状态。随访至术后1年时共有6例（8.7%）患者发生心血管病事件。术前存在抑郁焦虑状态，术前、术后发生心律失常，术中移植血管桥数量，术后住院时间、随访1年时发生心血管事件在两组间有显著性差异。使用体外循环、术后发生心律失常、术后住院时间延长可能与术后心血管事件的发生有关系。 CABG患者术后1年时存在抑郁焦虑状态的比例低于术前和出院前，但仍然有一定的发生率。术前、术后发生心律失常，术中移植血管桥数量，术后住院时间、术前存在抑郁焦虑等不良情绪、术后1年内发生心血管事件可能是术后1年时存在抑郁焦虑状态的危险因素，需要引起重视。病情重、手术复杂可能是术后发生心血管事件的危险因素，术前、出院前存在的不良情绪与心血管事件无关，而术后发生心血管事件可能加重术后1年的抑郁焦虑状态。关键词：前瞻性研究；抑郁；焦虑；冠状动脉旁路移植术；随访
其他摘要	To explore the presence of depression, anxiety and cardiac events after coronary artery bypass grafting (CABG) prospectively and comparably. To analysis influential factors of depression and anxiety ( peri-operation and 1 year after operation ), and the effection on cardiac events in the year after operation. We followed the patients who underwent scheduled consecutive CABG. We interviewed patients to assess depression, anxiety symptoms using self-rating depression scale( SDS) and self-rating anxiety scale（SAS）before operation , before discharge and 1 year after operation. And cardiac events were also identified. All patients were divided into the group with depression and/or anxiety symptoms or the other group without depression and/or anxiety symptoms 3 times according to depression and anxiety symptoms before operation , before discharge and 1 year after operation. 69 patients completed the follow-up.24 patients (34.8%) had depression and/or anxiety symptoms before CABG, 31 patients (44.9%) had depression and/or anxiety symptoms before discharge, and 10 patients (14.5%) had depression and/or anxiety symptoms 1 year after operation. 6 patients(8.7%) had cardiac events, and 5 patients were re-admitted. Arhythmia before and after operation, the quantity of blood vessel grafted, length of stay , depression and anxiety symptoms before operation, cardiac events may lead to depression and anxiety symptoms 1 year after operation. The use of cardiopulmonary bypass grafting (CPB), Arhythmia after operation, the prolonged length of stay are influential factors of cardiac events. Though the incidence of depression and/or anxiety symptoms 1 year after operation is lower than before operation and before discharge, it is high still. Arhythmia before and after operation, the more blood vessels grafted, the prolonged length of stay , depression and anxiety symptoms before operation and cardiac events could be risk factors of depression and anxiety symptoms 1 year after operation. Much attention must be paid to this phenomenon. Heavy patient's condition, complicated surgery are risk factors of cardiac events, and bad emotion before operation and before discharge are independent to cardiac events. Key words： perspective research; depression；anxiety; coronary artery bypass grafting; follow up
关键词	前瞻性研究抑郁焦虑冠状动脉旁路移植术随访
学位类型	硕士
语种	中文
学位授予单位	中国科学院心理研究所
学位授予地点	心理研究所
文献类型	学位论文
条目标识符	http://ir.psych.ac.cn/handle/311026/4426
专题	中国科学院心理研究所回溯数据库(1956-2010)
推荐引用方式 GB/T 7714	王忠杰. 冠状动脉旁路移植术后抑郁焦虑状态随访和分析[D]. 心理研究所. 中国科学院心理研究所,2009.

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