摘要目的：探讨心理护理联合经口内镜下环形肌切开术( POEM)治疗贲门失弛缓症( AC)的效果。方法选择2011年6月—2012年6月确诊AC行POEM手术患者80例,围术期给予心理干预。手术前后采用Eckardt评分比较患者AC临床症状改善情况,采用汉密尔顿焦虑量表( HAMA)、汉密尔顿抑郁量表( HAMD)比较患者心理改善情况。结果80例AC患者术前Eckardt评分平均(8±3)分,术后3个月平均(2±2)分,术后6个月平均(2± 1)分,手术前后比较差异有统计学意义(H=155.613,P<0.01)。术前HAMA>14分患者19例,术后3个月降至5例,手术前后患者焦虑情况比较差异有统计学意义(χ2=19.030,P<0.01)；术前HAMD>20分患者12例,术后3个月降至3例,手术前后患者抑郁情况比较差异有统计学意义(χ2=11.522,P<0.01)。结论 POEM手术联合心理护理治疗AC对焦虑抑郁情绪的改善及临床症状的缓解具有良好的效果,并发症少,安全可行。

abstractsObjective To explore the application of psychological nursing among the achalasia of cardia ( AC) patients with peroral endoscopic myotomy ( POEM) . Methods From June 2011 to June 2012 in the First Teaching Hospital of Xinjiang Medical University and the Soochow University, a total of 80 patients confirmed AC underwent POEM operation, treated with psychological nursing in perioperative period. The improvement of psychological status before and after intervention were compared by Hamilton anxiety scale ( HAMA) , Hamilton depression scale ( HAMD) and the Eckardt score. Results Before operation, the average score of Eckardt was (8 ± 3), but 3 and 6 months after intervention this score decreased to (2 ± 2) and (2 ± 1) with statistical differences (H=155. 613,P<0. 01). Before operation, 19 patients acquired the score of HAMA over 14 and 20 patients over 20 scores, but this number fell to 3 cases after 3 months operation (χ2 =11. 522,P<0. 01). Conclusions The psychological nursing combined with POEM is a effective way to alleviate anxiety and clinical symptom for AC patients, and minimizes complications and is safe in clinical.