認知行為療法對顱內動脈瘤介入手術患者負性情緒的影響

尹慶+黃云娟++馬穎君++黃維一

[摘要] 目的 探討認知行為療法對顱內動脈瘤介入手術患者負性情緒的影響。 方法 選取南京醫科大學附屬無錫市人民醫院2016年1月～2017年3月收治的接受顱內動脈瘤介入手術治療的患者80例，采用隨機數字表法將其分為干預組和對照組，每組各40例。對照組給予常規治療和護理，干預組在對照組的基礎上給予認知行為療法。采用自行設計的一般資料調查表、焦慮自評量表（SAS）、抑郁自評量表（SDS）、疾病不確定感量表（MUIS）對干預前后的效果進行評價。 結果 干預前兩組患者SAS、SDS和MUIS評分差異無統計學意義（P > 0.05）。干預后，干預組SAS、SDS和MUIS評分均低于對照組，差異均有統計學意義（均P < 0.05）。 結論 認知行為療法可有效改善顱內動脈瘤介入手術患者的焦慮、抑郁情緒，減輕其疾病不確定感。

[關鍵詞] 認知行為療法；顱內動脈瘤；負性情緒

[中圖分類號] R473.72 [文獻標識碼] A [文章編號] 1673-7210（2017）10（b）-0147-05

The effect of cognitive behavior therapy on negative emotion in patients with intracranial aneurysm interventional surgery

YIN Qing1 HUANG Yunjuan2▲ MA Yingjun1 HUANG Weiyi1

1.Neurosurgical Intensive Care Unit， Wuxi People′s Hospital Affiliated to Nanjing Medical University， Jiangsu Province， Wuxi 214023， China； 2.Department of Nursing， Wuxi People′s Hospital Affiliated to Nanjing Medical University， Jiangsu Province， Wuxi 214023， China

[Abstract] Objective To investigate the effect of cognitive behavior therapy on negative emotion in patients with intracranial aneurysm interventional surgery. Methods Eighty patients underwent intracranial aneurysm interventional surgery in Wuxi People′s Hospital Affiliated to Nanjing Medical University from January 2016 to March 2017 were enrolled and allocated randomly into intervention group and control group according to the random number table， with 40 cases in each group. The control group received routine treatment and nursing， while the intervention group received cognitive behavior therapy on the basis of the control group. The self-designed general data questionnaire， self-rating anxiety scale （SAS）， self-rating depression scale （SDS） and Mishel uncertainty in illness scale （MUIS） were used to evaluate the effect before and after intervention. Results Before intervention， there were no significant differences in scores of SAS， SDS and MUIS between the two groups （P > 0.05）. After intervention， the scores of SAS， SDS and MUIS in the intervention group were significantly lower than those of control group， the differences were statistically significant （all P < 0.05）. Conclusion Cognitive behavior therapy can effectively improve the anxiety and depression of patients with intracranial aneurysm interventional surgery， and reduce the uncertainty of the disease.

[Key words] Cognitive behavior therapy； Intracranial aneurysm； Negative emotions

顱內動脈瘤是指局部腦血管壁異常導致的瘤樣突起，是一種常見且嚴重的腦部出血性疾病[1]，其發病率為5%～10%[2]，破裂出血后致死率約為50%[3]。隨著醫療技術的提高，血管內介入栓塞治療已成為顱內動脈瘤治療的有效手段[4]。雖然介入治療創傷較小，但因費用較高，存在動脈瘤破裂再出血、腦血管痙攣等并發癥[5]，加之患者對疾病和手術知識的缺乏，極易對患者的心理造成不良的應激反應，產生焦慮、抑郁情緒，增加疾病不確定感，進而影響患者睡眠質量、治療和康復。認知行為療法廣泛應用于臨床，研究證明[6-8]，認知行為療法能增強患者的心理應對能力，改善負性情緒，對多種疾病產生的焦慮、抑郁都有顯著效果。本研……