發(fā)布時(shí)間：2018-09-08 16:31

【摘要】：目的探討慢性鼻-鼻竇炎(CRS)患者行鼻內(nèi)鏡微創(chuàng)手術(shù)前的心理特點(diǎn)。方法選取2010年1月-2014年12月該院收治行鼻內(nèi)鏡微創(chuàng)手術(shù)的310例CRS患者為研究對(duì)象,歸為觀察組,同時(shí)選取同期的200名健康成人作為對(duì)照組,采用Zung焦慮自評(píng)量表(SAS)、Zung抑郁自評(píng)量表(SDS)、癥狀自評(píng)量表SCL-90來(lái)評(píng)估研究對(duì)象的情緒和心理狀態(tài),然后對(duì)鼻塞、流涕、頭痛、面部疼痛或壓迫感、精力下降、嗅覺(jué)減退等6個(gè)CRS癥狀進(jìn)行視覺(jué)模擬量表(VAS)評(píng)分。比較兩組患者的SAS和SDS標(biāo)準(zhǔn)分及SCL-90的因子分和總均分,通過(guò)單因素和多因素Logistic回歸分析篩選出患者發(fā)生焦慮和抑郁等不良情緒的影響因素。結(jié)果觀察組的SAS和SDS標(biāo)準(zhǔn)分均明顯高于對(duì)照組(P0.05)。觀察組中無(wú)、輕度、中度和重度焦慮者分別為247例(79.7%)、28例(9.0%)、22例(7.1%)和13例(4.2%),無(wú)、輕度、中度和重度抑郁者分別為228例(73.5%)、36例(11.6%)、26例(8.4%)和20例(6.5%)。觀察組SCL-90的軀體化、人際關(guān)系敏感、抑郁和焦慮等的因子分及總均分均明顯高于對(duì)照組(P0.05),且與SAS評(píng)分和SDS評(píng)分呈正相關(guān)(P0.05)。多因素Logistic分析結(jié)果表明,女性和合并哮喘是患者發(fā)生單純焦慮的獨(dú)立危險(xiǎn)因素(P0.05),女性、合并哮喘及變應(yīng)性鼻炎(AR)是患者發(fā)生單純抑郁的獨(dú)立危險(xiǎn)因素(P0.05),女性、鼻塞評(píng)分≥5分、頭痛評(píng)分≥5分是患者發(fā)生焦慮合并抑郁的獨(dú)立危險(xiǎn)因素(P0.05)。結(jié)論 CRS患者進(jìn)行鼻內(nèi)鏡微創(chuàng)手術(shù)前常合并焦慮、抑郁等不良情緒,故在進(jìn)行術(shù)前談話過(guò)程中應(yīng)注重其情緒和心理狀態(tài),及時(shí)進(jìn)行心理干預(yù)。
[Abstract]:Objective to investigate the psychological characteristics of patients with chronic rhinosinusitis (CRS) before endoscopic minimally invasive surgery. Methods from January 2010 to December 2014, 310 patients with CRS treated by endoscopic minimally invasive surgery were selected as the observation group and 200 healthy adults as the control group. Zung self-rating anxiety scale (SAS), (SDS), symptom Checklist (SCL-90) was used to assess the subjects' emotional and psychological state, and then they suffered from nasal obstruction, runny nose, headache, facial pain or pressure, and decreased energy. Visual analogue scale (VAS) was used for 6 CRS symptoms. The standard scores of SAS and SDS, the factor scores and the total average scores of SCL-90 were compared between the two groups, and the influencing factors such as anxiety and depression were screened by univariate and multivariate Logistic regression analysis. Results the standard scores of SAS and SDS in the observation group were significantly higher than those in the control group (P 0.05). In the observation group, there were 247 cases (79.7%) with mild, moderate and severe anxiety, 22 cases (7.1%) and 13 cases (4.2%) with mild, moderate and severe anxiety, and 228 cases (73.5%) with mild, moderate and severe depression (26 cases (8.4%) and 20 cases (6.5%) respectively) with mild, moderate and severe anxiety. The scores of somatization, interpersonal sensitivity, depression and anxiety of SCL-90 in the observation group were significantly higher than those in the control group (P0.05), and were positively correlated with the SAS score and SDS score (P0.05). The results of multivariate Logistic analysis showed that women and asthma were independent risk factors of simple anxiety (P0.05), and women with asthma and allergic rhinitis (AR) were independent risk factors of simple depression (P0.05). Headache score 鈮，

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