综合性康复干预对房颤射频消融术后患者负性情绪和生活质量的影响

吴佳佳 朱瑞斐 金敏丽

[摘要] 目的 探讨综合性康复干预对房颤射频消融术后患者负性情绪和生活质量的影响。 方法 选取2016年1月～2017年12月拟行射频消融术治疗的阵发性房颤患者78例，分为干预组和對照组。两组均采取射频消融术，对照组术后给予心理安慰、健康教育、饮食干预和心电图检测等干预措施。干预组在对照组基础上加用综合性康复干预，两组均干预12周。评估两组干预前后负性情绪和生活质量变化。 结果 干预12周后，两组SDS和SAS评分均较前下降（P<0.05或P<0.01），且干预组下降幅度更显著（P<0.05）；同时两组躯体功能、心理情感、社会功能和物质生活等4个分项评分均较前明显上升（P<0.05或P<0.01），且干预组上升值更显著（P<0.05）。 结论 综合性康复干预对房颤射频消融术后患者具有较好的效果，不仅可显著改善其焦虑、抑郁等负性情绪，改善其心理状态，而且可显著提高其生活质量，改善预后。

[关键词] 房颤；射频消融术；综合性康复干预；负性情绪；生活质量

[中图分类号] R541 [文献标识码] B [文章编号] 1673-9701（2018）25-0098-03

[Abstract] Objective To investigate the effect of comprehensive rehabilitation intervention on negative emotions and quality of life in the patients with atrial fibrillation after receiving radiofrequency ablation. Methods 78 cases of paroxysmal atrial fibrillation who were scheduled for radiofrequency ablation from January 2016 to December 2017 were selected. They were divided into intervention group and control group. Both groups were treated with radiofrequency ablation. The control group was given interventions such as psychological comfort， health education， dietary intervention， and electrocardiogram testing. The intervention group was further given comprehensive rehabilitation interventions on the basis of the control group. Both groups were given intervention for 12 weeks. The changes in negative emotions and quality of life were evaluated before and after intervention in both groups. Results After 12 weeks of intervention， the scores of SDS and SAS in both groups were lower than before（P<0.05 or P<0.01）， and the intervention group decreased more significantly（P<0.05）； at the same time， the scores of somatic function， psychological emotion， social function， and material life were significantly higher than before（P<0.05 or P<0.01）， and the increase in the intervention group was more significant （P<0.05）. Conclusion Comprehensive rehabilitation intervention has a favorable effect on the patients with atrial fibrillation after radiofrequency ablation. Not only can it significantly improve patients' negative emotions such as anxiety and depression， but also improve their psychological state， and it can also significantly improve their quality of life and improve their prognosis.

[Key words] Atrial fibrillation； Radiofrequency ablation； Comprehensive rehabilitation intervention； Negative emotions； Quality of life

房颤是一种心内科的常见心律失常疾病，以头晕、胸闷、心悸为重要症状，常伴不同程度的焦虑、抑郁等负性情绪，严重影响患者生活质量[1，2]。射频消融术是治疗房颤常用的治疗方法，但术中释放的高频电流对患者来说是强大的应激源，加重患者的焦虑、抑郁等负性情绪，影响其生活质量[3，4]。以往临床上对房颤射频消融术后患者采用心理安慰、健康教育等常规干预措施，但总体来说效果欠理想[5-7]。综合性康复干预是一种心理、行为、认知干预及出院后继续教育等多种康复干预措施，但其在房颤射频消融术后患者的应用国内报道不多[8]。本研究观察了综合性康复干预对房颤射频消融术后患者负性情绪和生活质量的影响，现报道如下。

1 资料与方法

1.1 一般资料

选取2016年1月～2017年12月我院心内科就诊拟行射频消融术治疗的阵发性房颤患者78例。……