2024 年第 7 期 第 0 卷

日间经皮冠状动脉介入患者围手术期接受心理干预对术后抑郁的影响

The effect of perioperative psychological intervention on postoperative depression in patients undergoing daytime percutaneous coronary intervention

作者：赵熠张喜维

英文作者：Zhao Yi Zhang Xiwei

单位：首都医科大学附属北京安贞医院门诊部，北京100029

英文单位：Department of Outpatient Beijing Anzhen Hospital Capital Medical University Beijing 100029 China

关键词：经皮冠状动脉介入；日间手术；心理干预；抑郁

英文关键词：Percutaneouscoronaryintervention;Daytimesurgery;Psychologicalintervention;Depression

• 摘要：

• 目的 探讨日间经皮冠状动脉介入（PCI）患者在围手术期接受心理干预是否能有效降低术后抑郁发生。方法 纳入首都医科大学附属北京安贞医院2023年9—10月收治的266例冠心病（冠状动脉粥样硬化性心脏病）并且行日间PCI的患者，将患者完全随机分为心理干预组（136例）和对照组（130例）。对照组患者围手术期只进行普通常规护理，心理干预组患者在普通常规护理之外联合了围手术期心理干预。使用汉密尔顿抑郁量表（HAMD）24项版本对患者进行术后抑郁情绪评估，将HAMD评分≥21分的患者定义为发生了术后抑郁。结果 心理干预组出院时HAMD评分≥21分比例低于对照组［11.8%(16/136)比20.8%(27/130)］，差异有统计学意义（P＜0.05）。多因素Logistic回归结果表明，在调整潜在混杂因素后，心理干预是患者术后抑郁发生的独立影响因素，并具有保护作用（比值比=0.41，95%置信区间：0.20～0.85，P=0.017）。结论 日间PCI患者围手术期接受心理干预可以降低术后抑郁的发生率。

• Objective To explore whether psychological intervention can effectively reduce the incidence of postoperative depression in patients undergoing percutaneous coronary intervention (PCI) during the perioperative period. Methods A total of 266 patients with coronary atherosclerotic heart disease who underwent daytime PCI in Beijing Anzhen Hospital, Capital Medical University from September to October 2023 were enrolled. The patients were randomly divided into the psychological intervention group (136 cases) and the control group (130 cases). Patients in the control group were only given routine nursing during the perioperative period, while patients in the psychological intervention group were given perioperative psychological intervention in addition to routine nursing. The Hamilton Depression Rating Scale (HAMD) 24-item version was used to assess patients′ depressive mood postoperatively. Patients with HAMD score ≥21 were defined as having postoperative depression. Results  The proportion of patients with HAMD score ≥21 at discharge in the psychological intervention group was lower than that in the control group ［11.8%(16/136) vs 20.8%(27/130)］(P＜0.05). The results of multivariate Logistic regression showed that after adjusting for potential confounding factors, psychological intervention was an independent influencing factor for the occurrence of postoperative depression in patients, and had a protective effect (odds ratio=0.41, 95% confidence interval: 0.20-0.85, P=0.017). Conclusion  Perioperative psychological intervention can reduce the incidence of postoperative depression in patients with daytime PCI.