Cross-sectional Survey Of Psychological Disorders,Risk Assessment And Intervention Strategies In Patients With Coronary Heart Disease After PCI

Objective:To study the cross section of psychological disorders in patients with coronary heart disease after PCI,the influencing factors were analyzed,to summarize the comprehensive intervention measures for psychological disorders and provide a strong guarantee for the rehabilitation of patients undergone PCI.Methods : From October 2016 to December 2017,the 200 patients with coronary heart disease after coronary angiography were randomly selected which in the cardiovascular department of the Third People’s Hospital of Zigong City.According to the difference of treatment methods,all patients were divided into two groups on average,namely non-PCI group and PCI group,with 100 cases in each group.All patients were investigated and compared the incidence of postoperative anxiety between the two groups.By comparing the basic information(sex,age,marital status,past medical history,family history,complications,educational background,occupation,work pressure,payment form of medical expenses,economic affordability,understanding of disease and operation,expectation of therapeutic effect,recent changes,worries about stent problems)and biochemical indicators(Blood type,blood lipid,blood sugar,hypersensitive C-reactive protein,creatinine,liver function,interleukin-6,homocysteine and so on.),heart color Super check left ventricular ejection fraction,left ventricular condition,left atrium condition,of two groups of patients.Through univariate and multivariate analysis,to evaluate the important influencing factors of anxiety and depression in patients undergoing stent implantation.Results:1.The incidence of mental disorders in all 200 patients with coronary heart disease was 38% after half a year.In PCI group,the incidence was 32% after half a year,and in non-PCI group was 6%.There was no statistical significance in the incidence of SAS and SDS after operation between the two groups in 1 month(P > 0.05).The incidence of SAS and SDS was significantly different after 3 months and 6 months(P < 0.05).2.There was no statistical significance in gender,age,marital status,past medical history,occupation and BMI index between anxiety,depression and non-anxiety depression patients in PCI group after 6 months(P > 0.05).There were significant differences between anxiety-depression and non-anxiety-depression patients in terms of medical expense payment,economic affordability,understanding of disease and operation,expectation,recent family changes,combined with other diseases and worrying about stent problems in Six months after PCI,(P < 0.05).3.There was no significant difference in TG,TC,LDL-C,HDL-C,ALT,AST,BUN,GLU,EF,LA,LV,CK-MB between anxiety-depression and non-anxiety-depression patients after six months in PCI group(P > 0.05).However,there were significant differences in Hs-CRP,blood group,IL-6 and HCY in patients with anxiety and depression after six months in PCI group(P < 0.05).At the same time,anxiety and depression in PCI group were significantly correlated with medical expense payment,affordability,understanding of disease and operation,expectation,recent family changes,combined with other diseases,worrying about stent problems,Hs-CRP,IL-6,blood type and HCY after half a year(P < 0.05).4.The Independent factors affecting anxiety and depression after stent implantation included poor economic endurance,low understanding of disease and operation,high expectation of therapeutic effect,recent family changes,complications with other diseases,worries about stent problems,Hs-CRP,type A blood,IL-6,HCY,etc.(P < 0.05).5.The scores of SAS and SDS in the comprehensive psychological intervention group were significantly lower than those in the conventional psychological intervention group(P < 0.05).The incidence of anxiety and depression was significantly lower than that of routine psychological intervention group(P < 0.05).Conclusion: Patients with coronary heart disease after PCI have a higher incidence of mental disorders,which should be paid more attention in clinic.The independent factors affecting the psychological disorders of patients with coronary heart disease after PCI are the payment method of medical expenses,economic affordability,patients’ understanding of disease and operation,and their expectation of therapeutic effect,recent family changes,merger of other chronic diseases,worries about stent problems and inflammatory factors.Comprehensive psychological intervention can effectively improve the psychological disorders of patients.Implementing comprehensive intervention measures for related risk factors and strengthening preoperative communication with patients,adding preoperative psychological tests as one of the measures of preoperative communication,These will prevent and reduce the occurrence of psychological disorders in patients after PCI.