摘 要
经皮冠状动脉介入治疗(PCI)是治疗冠心病的重要手段，但术后患者普遍存在焦虑、抑郁等不良心理状态，影响康复效果和生活质量。本研究旨在探讨PCI术后患者心理状态变化规律及干预措施，为临床护理提供依据。采用横断面调查与前瞻性队列研究相结合的方法，选取某三甲医院2019年1月至2021年12月期间326例PCI术后患者作为研究对象，通过Zung氏焦虑自评量表(SAS)、抑郁自评量表(SDS)评估患者心理状况，并分析相关影响因素。结果显示，术后即刻焦虑发生率为47.85%，抑郁发生率为31.59%，随着时间推移，焦虑抑郁水平逐渐下降但仍显著高于正常人群；年龄、文化程度、家庭支持等因素对心理状态有重要影响。基于此，构建了以心理疏导为核心，结合健康教育、家属参与的综合干预模式，干预组患者焦虑抑郁评分明显低于对照组(P0.05)，且术后恢复情况更佳。研究表明，系统化的心理干预能够有效改善PCI术后患者的心理状态，提高其生活质量，为优化临床护理路径提供了新思路，创新性地将家属纳入干预体系，强调了家庭支持在患者康复中的关键作用，为同类研究提供了参考。
关键词：经皮冠状动脉介入治疗；心理状态；焦虑抑郁；综合干预；家庭支持
Abstract
Percutaneous coronary intervention (PCI) is a critical treatment modality for coronary heart disease; however, postoperative patients commonly experience adverse psychological states such as anxiety and depression, which negatively impact rehabilitation outcomes and quality of life. This study aimed to investigate the patterns of psychological state changes and intervention measures in patients following PCI, providing evidence for clinical nursing. A combined cross-sectional survey and prospective cohort study design was employed, selecting 326 patients who underwent PCI from January 2019 to December 2021 at a tertiary hospital. The Zung Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) were utilized to assess psychological status, with analyses conducted on relevant influencing factors. Results indicated an immediate postoperative anxiety incidence rate of 47.85% and a depression incidence rate of 31.59%, both of which gradually decreased over time but remained significantly higher than those in the general population. Factors such as age, educational level, and family support were found to have significant impacts on psychological states. Based on these findings, a comprehensive intervention model centered on psychological counseling, combined with health education and family involvement, was developed. Patients in the intervention group exhibited markedly lower anxiety and depression scores compared to the control group (P0.05), with better postoperative recovery. This study demonstrates that systematic psychological interventions can effectively improve the psychological state of patients following PCI, enhancing their quality of life and offering new insights for optimizing clinical nursing pathways. Innovatively incorporating family members into the intervention system underscores the crucial role of family support in patient rehabilitation, providing a reference for similar studies.
Keywords：Percutaneous Coronary Intervention；Psychological State；Anxiety And Depression；Comprehensive Intervention；Family Support
目 录
摘 要 I
Abstract II
引 言 1
第一章 经皮冠状动脉介入治疗概述 2
1.1 介入治疗的原理与技术 2
1.2 术后常见生理反应 2
1.3 围手术期管理要点 3
第二章 术后患者心理状态变化特征 4
2.1 术前焦虑与恐惧分析 4
2.2 术后早期心理适应过程 4
2.3 中长期心理状态演变趋势 5
第三章 心理状态变化的影响因素研究 7
3.1 患者个体差异分析 7
3.2 医疗环境对心理的影响 7
3.3 家庭社会支持系统的作用 8
第四章 心理干预措施及效果评估 9
4.1 常用心理干预方法 9
4.2 干预方案的实施路径 9
4.3 干预效果的量化评价 10
结 论 11
参考文献 12
致 谢 13
