發(fā)布時(shí)間：2018-09-05 18:05

【摘要】：目的:初步研究功能性鼻竇內(nèi)窺鏡手術(shù)(Functional Endoscopic Sinus Surgery,FESS)對慢性鼻-鼻竇炎(chronic rhinosinusitis,CRS)患者的情緒和心理狀態(tài)的改善狀況,初步探討在FESS術(shù)后隨訪中加入情緒、心理及精神方面的項(xiàng)目作為重要的愈合指標(biāo)的可行性。方法:采用漢密頓抑郁情緒量表(Hamilton Depression Scale,HAMD)、漢密頓焦慮情緒量表(Hamilton Anxiety Scale,HAMA)在術(shù)前一周內(nèi)及術(shù)后3月對川北醫(yī)學(xué)院附屬廣元市中心醫(yī)院耳鼻喉頭頸外科收治的62例CRS患者評估其心理狀態(tài),同時(shí)隨機(jī)選取同期來本院體檢的健康成人52人歸為對照組。并在術(shù)后發(fā)放隨訪卡定期隨訪評估患者鼻部及心理恢復(fù)情況。結(jié)果:1、根據(jù)HAMD及HAMA總分結(jié)果顯示,CRS患者組術(shù)前總平均分高于健康對照組,且在術(shù)后均有明顯降低,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。2、將HAMD和HAMA評分在一起進(jìn)行分組,分為正常組、單獨(dú)焦慮抑郁組和焦慮抑郁共病組,CRS患者術(shù)前各組分別有27(44%)、13(21%)和22人(35%),術(shù)后各組分別有48(75%)、8(12%)和8人(13%),手術(shù)前后患者組情緒障礙發(fā)生率均高于健康對照組,差異有統(tǒng)計(jì)學(xué)意義(χ2=24.194,P0.0001)。兩組均無重度焦慮抑郁障礙患者。3、經(jīng)相關(guān)性分析,術(shù)前HAMA總分與術(shù)前HAMD總分,術(shù)后HAMA總分與術(shù)后HAMD總分均存在線性相關(guān),相關(guān)性均存在統(tǒng)計(jì)學(xué)意義(P0.05),且均為正相關(guān)。結(jié)論:慢性鼻-鼻竇炎對于患者焦慮、抑郁情緒有負(fù)面作用,經(jīng)功能性鼻竇內(nèi)窺鏡手術(shù)術(shù)后的患者負(fù)性情緒均較術(shù)前有所改善。但由于部分患者術(shù)后仍有部分負(fù)性情緒的存在,為長期關(guān)注該部分患者的情緒心理健康,對其作出客觀的評估對比,臨床將精神情緒評分作為術(shù)后愈合的重要指標(biāo)是非常必要的。
[Abstract]:Objective: to study the improvement of emotional and psychological status in patients with chronic rhinosinusitis (chronic rhinosinusitis,CRS) after functional endoscopic sinus surgery (Functional Endoscopic Sinus Surgery,FESS), and to explore the application of emotion in the follow-up of FESS. Psychological and mental aspects of the project as an important indicator of healing feasibility. Methods: 62 patients with CRS were treated with Hamilton Depression scale (Hamilton Depression Scale,HAMD) and Hamilton anxiety scale (Hamilton Anxiety Scale,HAMA) in the first week before operation and 3 months after operation in the department of otolaryngology and head and neck surgery of Guangyuan City Central Hospital affiliated to Chuanbei Medical College. To assess their mental state, At the same time, 52 healthy adults were randomly selected as control group. Follow-up cards were issued to assess the nasal and psychological recovery of patients. Results: according to the total score of HAMD and HAMA, the preoperative average score in the HAMD group was higher than that in the healthy control group, and the difference was statistically significant (P0.05) .2.The HAMD and HAMA scores were divided into normal group. There were 27 (44%), 13 (21%) and 22 (35%) patients with CRS before operation and 48 (75%) with 12% and 8 (13%) with CRS, respectively. The incidence of emotional disorders in patients before and after operation was significantly higher than that in healthy controls (蠂 2 24. 194 P 0. 0001). The correlation analysis showed that the total score of HAMA was linearly correlated with the total score of HAMD before operation, the total score of HAMA and the total score of HAMD after operation, and the correlation was statistically significant (P0.05). Conclusion: chronic rhinosinusitis has negative effects on anxiety and depression. However, because some patients still have some negative emotions after operation, in order to pay close attention to their emotional mental health for a long time, the objective evaluation and comparison are made. It is necessary to treat psychosis score as an important index of postoperative healing.
【學(xué)位授予單位】：川北醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R765.9

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