本文選題：焦慮　切入點(diǎn)：抑郁　出處：《山西醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:探討本地區(qū)住院患者的焦慮抑郁狀態(tài)與其肝硬化進(jìn)展的關(guān)系,以期為患者提供心理疏導(dǎo),改善患者病情,提高患者生活質(zhì)量。方法:收集于2016年8月至2016年11月在山大二院消化內(nèi)科診斷為肝硬化的住院病人,收集患者一般信息資料,Child-Pugh評分及分級,采用焦慮自評量表(SAS)、抑郁自評量表(SDS)對患者焦慮抑郁情況進(jìn)行問卷調(diào)查,對照組選擇國內(nèi)SAS、SDS評分常模。觀察患者焦慮抑郁狀態(tài)與肝硬化嚴(yán)重程度的關(guān)系。結(jié)果:研究包括57例肝硬化患者,男29例,女28例,SAS標(biāo)準(zhǔn)分46.84±8.24,SDS標(biāo)準(zhǔn)分48.64±8.31,均高于國內(nèi)常模(P0.05),處于焦慮30例(52.63%),其中29例(50.88%)屬于輕度,1例(1.75%)屬于中度;處于抑郁28例(49.12%),其中24例(42.11%)屬于輕度,4例(7.02%)屬于中度,均無重度焦慮或重度抑郁,焦慮合并抑郁19例(33.33%);57例患者中有2例患者的SDS和SAS評分均低于50分,病程是10年和30年,Child-Pugh得分均為5分;不同肝硬化進(jìn)展患者的SAS、SDS標(biāo)準(zhǔn)分差異有統(tǒng)計(jì)學(xué)意義(P0.05);不同年齡、婚姻情況患者的SAS標(biāo)準(zhǔn)分差異有統(tǒng)計(jì)學(xué)意義(P0.05),SDS標(biāo)準(zhǔn)分差異無統(tǒng)計(jì)學(xué)意義(P0.05);不同性別、住院天數(shù)、經(jīng)濟(jì)情況、學(xué)歷、醫(yī)保、病程的患者SAS、SDS標(biāo)準(zhǔn)分差異無統(tǒng)計(jì)學(xué)意義(P0.05),但女性患者焦慮、抑郁和兩者兼有發(fā)病率(67.86%、53.57%、39.29%)明顯高于男性患者(37.93%、44.83%、27.59%),年收入低、住院時(shí)間長、新農(nóng)合的患者其焦慮抑郁得分均比年收入高、住院時(shí)間短、市醫(yī)保的患者得分高;不同類型患者的SAS、SDS標(biāo)準(zhǔn)分差異無統(tǒng)計(jì)學(xué)意義(P0.05),混合型肝硬化SAS、SDS標(biāo)準(zhǔn)分最高。結(jié)論:本研究表明焦慮抑郁在肝硬化患者中廣泛存在,受多種因素影響,并且與肝硬化進(jìn)展關(guān)系密切,有部分肝硬化患者病程很長,但是心態(tài)較好,病情反而進(jìn)展慢,說明良好的心理狀態(tài)有助于疾病恢復(fù),延緩疾病進(jìn)展;老年女性,收入低,婚姻不滿意,肝臟損害越嚴(yán)重的混合型肝硬化患者,是心理障礙發(fā)生的高危人群,必要時(shí)應(yīng)采取心理治療;本結(jié)論提示臨床上需要重視肝硬化患者心理情緒問題,治療上應(yīng)心肝兼治。
[Abstract]:Objective: to explore the relationship between anxiety and depression and the progression of liver cirrhosis in order to provide psychological guidance, improve patients' condition and improve their quality of life.Methods: from August 2016 to November 2016, the inpatients diagnosed as cirrhosis in the Department of Digestive Medicine, second Hospital of Shandong University were collected, and the general information of the patients were collected, and the Child-Pugh score and grading were collected.Self-Rating anxiety scale (SAS) and Self-Rating Depression scale (SDS) were used to investigate the anxiety and depression of patients.To observe the relationship between anxiety and depression and the severity of cirrhosis.Results: the standard score of SAS in 57 cirrhotic patients (male 29, female 28) was 46.84 鹵8.24 渭 m SDS (48.64 鹵8.31), which was higher than that in domestic norm (P 0.05), and anxiety was found in 30 cases (52.63), among which 29 cases (50.88) were mild (1.75).The score of Child-Pugh was 5 in 10 years and 30 years, the difference of SDS standard score in patients with different liver cirrhosis was statistically significant (P 0.05).There was no significant difference in SAS standard scores among marital patients (P 0.05), and there was no significant difference in SAS standard scores between different sex, length of stay, economic condition, educational background, medical insurance.The patients with short hospitalization time and high score of medical insurance had no significant difference in SDS standard score of different types of patients (P 0.05), while the patients with mixed liver cirrhosis had the highest score of SAS SDS standard.Conclusion: this study shows that anxiety and depression are widespread in patients with liver cirrhosis, influenced by many factors, and are closely related to the progression of cirrhosis. Some patients with liver cirrhosis have a long course of disease, but their mentality is good, and the disease progress is slow.It shows that a good psychological state is helpful to the recovery of the disease and slows down the progress of the disease. Elderly women with low income, dissatisfied marriage and more serious liver damage are the high risk group for the occurrence of psychological disorders.This conclusion suggests that attention should be paid to the psychological and emotional problems in patients with liver cirrhosis and both heart and liver should be treated.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R575.2;R749

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