作者：李菀茹，赵海波

单位：

100000北京市，首都医科大学附属北京朝阳医院心脏一病区

Units：

Department of Cardiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100000, China

关键词：

主动脉瓣狭窄；经导管主动脉瓣置换；正念减压疗法；心理暗示

Keywords：

Aortic valve stenosis; Transcatheter aortic valve replacement; Mindfulness-based stress reduction; Psychological suggestion

CLC：

R 542.52

DOI：

10.12114/j.issn.1008-5971.2024.00.051

Funds：

摘要：

目的　探讨正念减压疗法联合心理暗示疗法在经导管主动脉瓣置入术（TAVI）后主动脉瓣狭窄患者 中的应用效果。方法　选取2022年首都医科大学附属北京朝阳医院收治的行TAVI的主动脉瓣狭窄患者100例作为研 究对象，采用随机数字表法将其分为对照组和研究组，每组50例。TAVI后3 d，对照组患者在常规护理基础上接受 心理暗示疗法干预，研究组患者在对照组基础上接受正念减压疗法干预，两组均干预42 d。比较两组干预前及干预 42 d汉密尔顿焦虑量表（HAMA）、汉密尔顿抑郁量表（HAMD）、五因素正念度量表（FFMQ）、一般自我效能感 量表（GSES）评分，干预前及干预7、15、30、42 d欧洲五维度健康量表（EQ-5D）评分。结果　干预42 d，研究组 HAMA、HAMD评分低于对照组，FFMQ评分高于对照组（P＜0.05）。干预42 d，研究组日常生活行为管理、疾病管 理、认知症状管理维度评分高于对照组（P＜0.05）。干预7 d，两组EQ-5D评分分别高于本组干预前（P＜0.05）；干 预15 d，两组EQ-5D评分分别高于本组干预前、干预7 d（P＜0.05）；干预30 d，两组EQ-5D评分分别高于本组干预 前及干预7、15 d（P＜0.05）；干预42 d，两组EQ-5D评分分别高于本组干预前及干预7、15、30 d（P＜0.05）；干预 后7、15、30、42 d，研究组EQ-5D评分高于对照组（P＜0.05）。结论　正念减压疗法联合心理暗示疗法可有效减轻 TAVI后主动脉瓣狭窄患者焦虑、抑郁情绪，提高其正念觉知水平、自我效能感及健康状况。

Abstract：

Objective To investigate the application effect of mindfulness-based stress reduction combined with psychological suggestion therapy in patients with aortic valve stenosis after transcatheter aortic valve implantation (TAVI) . Methods A total of 100 patients with aortic valve stenosis who underwent TAVI in Beijing Chaoyang Hospital, Capital Medical University in 2022 were selected as the research objects. They were divided into control group and study group by random number table method, with 50 cases in each group. Three days after TAVI, the patients in the control group were treated with psychological suggestion therapy on the basis of routine nursing, and the patients in the study group were treated with mindfulness-based stress reduction on the basis of the control group. Both groups were intervened for 42 days. The scores of Hamilton Anxiety Scale (HAMA) , Hamilton Depression Scale (HAMD) , Five Facet Mindfulness Questionaire (FFMQ) and General Self-Efficacy Scale (GSES) before intervention and at 42 days after intervention, EuroQol Five-Dimensional Questionnaire (EQ-5D) score before intervention and at 7, 15, 30, 42 days after intervention were compared between the two groups. Results At 42 days after intervention, the scores of HAMA and HAMD in the study group were lower than those in the control group, and the FFMQ score was higher than that in the control group (P < 0.05) . At 42 days after intervention, the scores of daily life behavior management, disease management and cognitive symptom management dimension in the study group were higher than those in the control group (P < 0.05) . At 7 days after intervention, the EQ-5D scores of the two groups were higher than those before intervention, respectively (P < 0.05) . At 15 days after intervention, the EQ-5D scores of the two groups were higher than those before intervention and at 7 days after intervention, respectively (P < 0.05) . At 15 days after intervention, the EQ-5D scores of the two groups were higher than those before intervention, at 7 days and 15 days after intervention, respectively (P < 0.05) . At 42 days after intervention, the EQ-5D scores of the two groups were higher than those before intervention and at 7 days, 15 days and 30 days after intervention (P < 0.05) . At 7, 15, 30 and 42 days after intervention, the EQ-5D score in the study group was higher than that in the control group (P < 0.05) . Conclusion Mindfulness-based stress reduction combined with psychological suggestion therapy can effectively reduce anxiety and depression in patients with aortic valve stenosis after TAVI, and improve their level of mindfulness awareness, self-efficacy and health status.

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