| 【Background and Objective】In China,cardiovascular disease(CVD)is still the leading cause of death,accounting for more than 40% of all deaths.At present,the total number of cardiovascular diseases in China is about 290 million,of which 11 million are coronary atherosclerotic heart disease.According to statistics,the incidence of CVD is continuing to rise,and it is developing in a younger trend,and its social harm has increased significantly.With the rapid development of diagnosis and treatment technology,percutaneous coronary intervention(PCI)has become an important means of treating coronary heart disease because of its short surgical procedure,small trauma,good effect and rapid recovery.As PCI technology matures,the mortality rate of coronary heart disease is significantly reduced,the social burden is gradually reduced,and the physical symptoms of patients are significantly improved.However,as an invasive treatment method,some patients will have different degrees of psychological disorders.There are obvious psychological stress reactions such as anxiety and depression during the perioperative period,which have an adverse effect on the prognosis of surgery.In recent years,under the influence of “Bio-psycho-social medicine model”,clinicians not only pay attention to the physical state of patients,but also pay more and more attention to the psychological state of patients during perioperative period.A large number of studies have shown that anxiety and depression have a significant impact on the long-term prognosis of PCI.However,the effect of preoperative anxiety and depression on PCI is rarely observed,and the successful implementation of surgery is very important in the treatment of patients with severe coronary heart disease.The aim of this study was to investigate the correlation between perioperative anxiety and depression in patients with PCI and the occurrence of adverse events during surgery,and to further explore other factors that affect the smooth progression of PCI,and to provide reference materials for clinicians to identify and intervene the patients with excessive anxiety and depression in the perioperative period,in order to improving the prognosis and quality of life of patients.【Methods】A total of 275 patients were selected who underwent PCI for the first time at The First Affiliated Hospital of Dalian Medical University from Jun.2017 to Jun.2018.After obtaining the informed consent of the patients and their families,Self-Rating Depression Scale and Self-Rating Anxiety Scale were selected for psychological evaluation of the perioperative patients on one day before PCI.If can’t fill it out independently,the researcher will read the scale’s options and the patient will choose it.Then,the researcher will fill in the scale according to the patient’s choice.Collect relevant factors that may affect the smooth operation of the operation,such as age,gender,coronary heart disease type,hypertension,diabetes,hyperlipidemia,smoking and drinking,liver and kidney function,troponin,B-type natriuretic peptide(BNP),blood uric acid,left ventricular ejection fraction(LVEF),ventricular wall motion abnormalities,lesion sites,operation time,etc.And recorded whether adverse events occurred during PCI,such as vagus reflex,chest pain worse,elevated blood pressure,new heart failure,new arrhythmia.Correlation analysis was used to analyze whether there was a correlation between preoperative anxiety and depression and adverse events during the operation.Univariate analysis and multivariate regression analysis were performed to analyze the other factors that may affect the adverse events during the operation.【Results】1.Analysis of anxiety and depression before PCI: 79 cases(28.7%)with anxiety before PCI,including 50 cases mild,24 cases moderate,and 5 cases severe.88 cases(32.0%)of depression before PCI,including 49 cases were mild,30 cases were moderate,and 9 cases were severe.53 cases(19.3%)with coexisting anxiety and depression before PCI.2.Analysis of adverse events during PCI: adverse events during operation 68 cases(24.7%),38 cases of significantly increased intraoperative blood pressure,15 cases of vagal reflex,7 cases of chest pain worse,5 cases of new arrhythmias and 3 cases of new heart failure.3.Correlation analysis showed that there was a correlation between preoperative anxiety and depression and the occurrence of adverse events during PCI,the difference was statistically significant(P <0.001);R=0.298 and R= 0.291(all P values were less than 0.05).4.Univariate analysis showed that serum uric acid level,operation time,LVEF had a significant effect on adverse events during PCI(P <0.05).Gender,age,history of heart disease,type of coronary heart disease,risk factors for coronary heart disease,liver and kidney function,troponin,BNP,ventricular wall motion abnormalities,and lesion sites had no effect(P >0.05).5.Multivariate logistic regression analysis: anxiety,depression,blood uric acid,and operation time had an effect on adverse events during PCI(P <0.05);LVEF had no effect on adverse events during PCI(P > 0.05).6.Analysis of the effects of anxiety and depression severity on adverse events during PCI: There was a linear trend between the severity of anxiety-depression and intraoperative adverse events(χ2 =23.251,28.828,and R=0.291,0.324,P <0.05).【Conclusion】1.Patients with coronary heart disease have anxiety and depression during the perioperative period of PCI.These negative emotions may affect the smooth progress of PCI.2.Anxiety,depression,blood uric acid,and operation time are independent risk factors for adverse events during PCI.3.There is a linear trend between the severity of anxiety-depression and adverse events during PCI,and it was positively correlated. |
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