疑难病杂志
疑難病雜誌
의난병잡지
Chinese Journal of Difficult and Complicated Cases
2015年
11期
1144-1146,1150
,共4页
胸痛%急诊%心理状态%临床特征
胸痛%急診%心理狀態%臨床特徵
흉통%급진%심리상태%림상특정
Chest pain%Emergency%Psychological state%Clinical features
目的：探讨急诊胸痛患者心理状态和临床特征。方法选取2012年2月—2015年2月急诊收治的胸痛患者287例，按照病因分为心源性胸痛组（CCP组， n ＝67）和非心源性胸痛组（NCCP组， n ＝220）。采用汉密尔顿焦虑量表（HAMA）、汉密尔顿抑郁量表（HAMD-17）评估2组患者的心理状态，以HAMA评分＞14分、HAMD-17评分＞7分判定为肯定焦虑和肯定抑郁，比较2组患者的心理状态及临床特征。结果 NCCP组患者平均年龄为（42?．1±10．8）岁，小于CCP组的（56．7±12．3）岁（ t ＝－1．847， P ＜0．05）；CCP组平均HAMA评分（13．24±4．28）分明显低于NCCP组（16．54±5．85）分（ t ＝2．293， P ＜0．05）；CCP组肯定焦虑和肯定抑郁发生率分别为40．3％（27／67）、29．9％（20／67），NCCP组患者分别为66．4％（146／220）、29．5％（65／220），NCCP组的肯定焦虑发生率明显高于CCP组（χ2＝4．394， P ＜0．05）；NCCP组患者死亡恐惧、害怕、过度换气、失控感及手脚麻木等伴随症状发生率明显高于CCP组，且发生4种以上伴随症状的比例明显高于CCP组（ P ＜0．05）；NCCP组患者病程≥6个月的比例明显高于CCP组（χ2＝4．904， P ＜0．05）。结论急诊胸痛患者的焦虑心理状态比较突出，大多数为NCCP患者，且临床特征为年龄相对较轻，心电图无明显异常，胸痛发作时特征性伴随症状较多。
目的：探討急診胸痛患者心理狀態和臨床特徵。方法選取2012年2月—2015年2月急診收治的胸痛患者287例，按照病因分為心源性胸痛組（CCP組， n ＝67）和非心源性胸痛組（NCCP組， n ＝220）。採用漢密爾頓焦慮量錶（HAMA）、漢密爾頓抑鬱量錶（HAMD-17）評估2組患者的心理狀態，以HAMA評分＞14分、HAMD-17評分＞7分判定為肯定焦慮和肯定抑鬱，比較2組患者的心理狀態及臨床特徵。結果 NCCP組患者平均年齡為（42?．1±10．8）歲，小于CCP組的（56．7±12．3）歲（ t ＝－1．847， P ＜0．05）；CCP組平均HAMA評分（13．24±4．28）分明顯低于NCCP組（16．54±5．85）分（ t ＝2．293， P ＜0．05）；CCP組肯定焦慮和肯定抑鬱髮生率分彆為40．3％（27／67）、29．9％（20／67），NCCP組患者分彆為66．4％（146／220）、29．5％（65／220），NCCP組的肯定焦慮髮生率明顯高于CCP組（χ2＝4．394， P ＜0．05）；NCCP組患者死亡恐懼、害怕、過度換氣、失控感及手腳痳木等伴隨癥狀髮生率明顯高于CCP組，且髮生4種以上伴隨癥狀的比例明顯高于CCP組（ P ＜0．05）；NCCP組患者病程≥6箇月的比例明顯高于CCP組（χ2＝4．904， P ＜0．05）。結論急診胸痛患者的焦慮心理狀態比較突齣，大多數為NCCP患者，且臨床特徵為年齡相對較輕，心電圖無明顯異常，胸痛髮作時特徵性伴隨癥狀較多。
목적：탐토급진흉통환자심리상태화림상특정。방법선취2012년2월—2015년2월급진수치적흉통환자287례，안조병인분위심원성흉통조（CCP조， n ＝67）화비심원성흉통조（NCCP조， n ＝220）。채용한밀이돈초필량표（HAMA）、한밀이돈억욱량표（HAMD-17）평고2조환자적심리상태，이HAMA평분＞14분、HAMD-17평분＞7분판정위긍정초필화긍정억욱，비교2조환자적심리상태급림상특정。결과 NCCP조환자평균년령위（42?．1±10．8）세，소우CCP조적（56．7±12．3）세（ t ＝－1．847， P ＜0．05）；CCP조평균HAMA평분（13．24±4．28）분명현저우NCCP조（16．54±5．85）분（ t ＝2．293， P ＜0．05）；CCP조긍정초필화긍정억욱발생솔분별위40．3％（27／67）、29．9％（20／67），NCCP조환자분별위66．4％（146／220）、29．5％（65／220），NCCP조적긍정초필발생솔명현고우CCP조（χ2＝4．394， P ＜0．05）；NCCP조환자사망공구、해파、과도환기、실공감급수각마목등반수증상발생솔명현고우CCP조，차발생4충이상반수증상적비례명현고우CCP조（ P ＜0．05）；NCCP조환자병정≥6개월적비례명현고우CCP조（χ2＝4．904， P ＜0．05）。결론급진흉통환자적초필심리상태비교돌출，대다수위NCCP환자，차림상특정위년령상대교경，심전도무명현이상，흉통발작시특정성반수증상교다。
Objective To explore the mental status and clinical characteristics of patients with acute chest pain. Methods From February 2012 to February 2015, 287 cases of patients with chest pain in emergency department of the hospi-tal were selected, according to the etiology, they were divided into cardiaa chest pain group ( CCP group, n =67 cases) and non-cardiac chest pain group ( NCCP group, n =220 cases) .The Hamilton anxiety scale ( HAMA) and the Hamilton depres-sion rating table (HAMD-17) were used to assess the psychological state of the patients in the two groups, HAMA score >14 points, HAMD 17 score >7 points were used to be determined as anxiety and depression, compared the two groups’ patients’ psychological state and its clinical characteristics.Results The average age of the patients in the NCCP group was (42.1 ± 10.8) years old, which was younger than those in CCP group (56.7 ±12.3) years old ( t =-1.847, P <0.05); CCP group’s mean HAMA score (13.24 ±4.28) was significantly lower than in NCCP group (16.54 ±5.85points, t =2.293, P <0.05); CCP group’ s anxiety and depression rate were 40.3% (27/67) and 29.9% (20/67), NCCP group were 66.4%(146/220) and 29.5% (65/220), NCCP group’ s incidence of anxiety was significantly higher than that of CCP group (χ2 =4.394, P <0.05), NCCP group’s patients’s fear of death, fear, hyperventilation, feeling out of control, numb-ness and other symptoms were significantly higher than CCP group, and the occurrence of more than 4 kinds of symptoms were higher than CCP group ( P <0.05), NCCP group’s course more than 6 months’ proportion was significantly higher than CCP group (χ2 =4.904, P <0.05).Conclusion The anxiety state of emergency patients with chest pain is more prominent, the majority was patients with NCCP, and the clinical features included younger age, no obvious abnormalities of ECG, the char-acteristics symptoms associated with chest pain.
