CAJ | 학술논문

目的：探讨心理护理联合经口内镜下环形肌切开术( POEM)治疗贲门失弛缓症( AC)的效果。方法选择2011年6月—2012年6月确诊AC行POEM手术患者80例,围术期给予心理干预。手术前后采用Eckardt评分比较患者AC临床症状改善情况,采用汉密尔顿焦虑量表( HAMA)、汉密尔顿抑郁量表( HAMD)比较患者心理改善情况。结果80例AC患者术前Eckardt评分平均(8±3)分,术后3个月平均(2±2)分,术后6个月平均(2± 1)分,手术前后比较差异有统计学意义(H=155.613,P<0.01)。术前HAMA>14分患者19例,术后3个月降至5例,手术前后患者焦虑情况比较差异有统计学意义(χ2=19.030,P<0.01)；术前HAMD>20分患者12例,术后3个月降至3例,手术前后患者抑郁情况比较差异有统计学意义(χ2=11.522,P<0.01)。结论 POEM手术联合心理护理治疗AC对焦虑抑郁情绪的改善及临床症状的缓解具有良好的效果,并发症少,安全可行。
목적：탐토심리호리연합경구내경하배형기절개술( POEM)치료분문실이완증( AC)적효과。방법선택2011년6월—2012년6월학진AC행POEM수술환자80례,위술기급여심리간예。수술전후채용Eckardt평분비교환자AC림상증상개선정황,채용한밀이돈초필량표( HAMA)、한밀이돈억욱량표( HAMD)비교환자심리개선정황。결과80례AC환자술전Eckardt평분평균(8±3)분,술후3개월평균(2±2)분,술후6개월평균(2± 1)분,수술전후비교차이유통계학의의(H=155.613,P<0.01)。술전HAMA>14분환자19례,술후3개월강지5례,수술전후환자초필정황비교차이유통계학의의(χ2=19.030,P<0.01)；술전HAMD>20분환자12례,술후3개월강지3례,수술전후환자억욱정황비교차이유통계학의의(χ2=11.522,P<0.01)。결론 POEM수술연합심리호리치료AC대초필억욱정서적개선급림상증상적완해구유량호적효과,병발증소,안전가행。
Objective To explore the application of psychological nursing among the achalasia of cardia ( AC) patients with peroral endoscopic myotomy ( POEM) . Methods From June 2011 to June 2012 in the First Teaching Hospital of Xinjiang Medical University and the Soochow University, a total of 80 patients confirmed AC underwent POEM operation, treated with psychological nursing in perioperative period. The improvement of psychological status before and after intervention were compared by Hamilton anxiety scale ( HAMA) , Hamilton depression scale ( HAMD) and the Eckardt score. Results Before operation, the average score of Eckardt was (8 ± 3), but 3 and 6 months after intervention this score decreased to (2 ± 2) and (2 ± 1) with statistical differences (H=155. 613,P<0. 01). Before operation, 19 patients acquired the score of HAMA over 14 and 20 patients over 20 scores, but this number fell to 3 cases after 3 months operation (χ2 =11. 522,P<0. 01). Conclusions The psychological nursing combined with POEM is a effective way to alleviate anxiety and clinical symptom for AC patients, and minimizes complications and is safe in clinical.