功能性鼻窦内窥镜手术对慢性鼻—鼻窦炎病人负面情绪改善的研究

发布时间：2018-09-05 18:05

【摘要】：目的:初步研究功能性鼻窦内窥镜手术(Functional Endoscopic Sinus Surgery,FESS)对慢性鼻-鼻窦炎(chronic rhinosinusitis,CRS)患者的情绪和心理状态的改善状况,初步探讨在FESS术后随访中加入情绪、心理及精神方面的项目作为重要的愈合指标的可行性。方法:采用汉密顿抑郁情绪量表(Hamilton Depression Scale,HAMD)、汉密顿焦虑情绪量表(Hamilton Anxiety Scale,HAMA)在术前一周内及术后3月对川北医学院附属广元市中心医院耳鼻喉头颈外科收治的62例CRS患者评估其心理状态,同时随机选取同期来本院体检的健康成人52人归为对照组。并在术后发放随访卡定期随访评估患者鼻部及心理恢复情况。结果:1、根据HAMD及HAMA总分结果显示,CRS患者组术前总平均分高于健康对照组,且在术后均有明显降低,差异有统计学意义(P0.05)。2、将HAMD和HAMA评分在一起进行分组,分为正常组、单独焦虑抑郁组和焦虑抑郁共病组,CRS患者术前各组分别有27(44%)、13(21%)和22人(35%),术后各组分别有48(75%)、8(12%)和8人(13%),手术前后患者组情绪障碍发生率均高于健康对照组,差异有统计学意义(χ2=24.194,P0.0001)。两组均无重度焦虑抑郁障碍患者。3、经相关性分析,术前HAMA总分与术前HAMD总分,术后HAMA总分与术后HAMD总分均存在线性相关,相关性均存在统计学意义(P0.05),且均为正相关。结论:慢性鼻-鼻窦炎对于患者焦虑、抑郁情绪有负面作用,经功能性鼻窦内窥镜手术术后的患者负性情绪均较术前有所改善。但由于部分患者术后仍有部分负性情绪的存在,为长期关注该部分患者的情绪心理健康,对其作出客观的评估对比,临床将精神情绪评分作为术后愈合的重要指标是非常必要的。
[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.
【学位授予单位】：川北医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R765.9

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