焦虑抑郁状态与肝硬化进展关系研究

发布时间：2018-04-08 14:12

本文选题：焦虑　切入点：抑郁　出处：《山西医科大学》2017年硕士论文

【摘要】：目的:探讨本地区住院患者的焦虑抑郁状态与其肝硬化进展的关系,以期为患者提供心理疏导,改善患者病情,提高患者生活质量。方法:收集于2016年8月至2016年11月在山大二院消化内科诊断为肝硬化的住院病人,收集患者一般信息资料,Child-Pugh评分及分级,采用焦虑自评量表(SAS)、抑郁自评量表(SDS)对患者焦虑抑郁情况进行问卷调查,对照组选择国内SAS、SDS评分常模。观察患者焦虑抑郁状态与肝硬化严重程度的关系。结果:研究包括57例肝硬化患者,男29例,女28例,SAS标准分46.84±8.24,SDS标准分48.64±8.31,均高于国内常模(P0.05),处于焦虑30例(52.63%),其中29例(50.88%)属于轻度,1例(1.75%)属于中度;处于抑郁28例(49.12%),其中24例(42.11%)属于轻度,4例(7.02%)属于中度,均无重度焦虑或重度抑郁,焦虑合并抑郁19例(33.33%);57例患者中有2例患者的SDS和SAS评分均低于50分,病程是10年和30年,Child-Pugh得分均为5分;不同肝硬化进展患者的SAS、SDS标准分差异有统计学意义(P0.05);不同年龄、婚姻情况患者的SAS标准分差异有统计学意义(P0.05),SDS标准分差异无统计学意义(P0.05);不同性别、住院天数、经济情况、学历、医保、病程的患者SAS、SDS标准分差异无统计学意义(P0.05),但女性患者焦虑、抑郁和两者兼有发病率(67.86%、53.57%、39.29%)明显高于男性患者(37.93%、44.83%、27.59%),年收入低、住院时间长、新农合的患者其焦虑抑郁得分均比年收入高、住院时间短、市医保的患者得分高;不同类型患者的SAS、SDS标准分差异无统计学意义(P0.05),混合型肝硬化SAS、SDS标准分最高。结论:本研究表明焦虑抑郁在肝硬化患者中广泛存在,受多种因素影响,并且与肝硬化进展关系密切,有部分肝硬化患者病程很长,但是心态较好,病情反而进展慢,说明良好的心理状态有助于疾病恢复,延缓疾病进展;老年女性,收入低,婚姻不满意,肝脏损害越严重的混合型肝硬化患者,是心理障碍发生的高危人群,必要时应采取心理治疗;本结论提示临床上需要重视肝硬化患者心理情绪问题,治疗上应心肝兼治。
[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 卤8.24 渭 m SDS (48.64 卤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.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R575.2;R749

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