阻塞性睡眠呼吸暂停低通气综合征治疗前后的心理改变及干预对策王振霖1�张孝文1�李源1�张革化1�刘贤1�李哈林2��[摘要]�目的:探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者的心理状况及综合性治疗对其的影响。方法:对85例OSAHS患者治疗前和治疗后不同时段的心理状况进行分析和对比。结果:OSAHS患者症状自评量表(SCL-90)躯体化、强迫、人际敏感、抑郁、焦虑、精神病性的因子分较国内常模明显增高(P<0.01)。SCL-90抑郁、焦虑因子分、Zung氏焦虑自评表(SAS)、汉密顿抑郁量表(HRSD)评分于治疗后1周、3个月依次递减,治疗前与治疗后1周差异有统计学意义,治疗后1周与3个月差异有统计学意义。结论:OSAHS患者存在显著的心理卫生障碍,综合性治疗有助于患者的身心康复。[关键词]�抑郁障碍;睡眠呼吸暂停低通气综合征,阻塞性;心理疗法��[中图分类号]�R563.8��[文献标志码]�A��[文章编号]�1001-1781(2006)12-0549-03Theeffectofcomprehensivetherapyonpsychologicalstateofobstructivesleepapnea-hypopneasyndromeWANGZhenlin1�ZHANGXiaowen1�LIYuan1ZHANGGehua1�LIUXian1�LIHalin2(1DepartmentofOtolaryngology-HeadandNeckSurgery,theThirdAffiliatedHospitalofSunYat-senUniversity,Guangzhou,510630,China;2DepartmentofPsychology,theFirstAffiliatedHospitalofHarbinMedicalUniversity)��Abstract�Objective:Toinvestigatepsychologicalstateofpatientswithobstructivesleepapnea-hypopneasyn-drome(OSAHS)andtheeffectofcomprehensivetherapyonit.Method:Eighty-fivepatientswereassessedwithSCL-90,SASandHRSDondifferenttime.StatisticaltreatmentwasperformedwithTtest.Result:Thesubscoresofsomatization,anxiety,depression,psychoticismofSCL-90inOSAHSwerehigherthanaveragescoresinCh-ina.TheSCL-90,SAS,HRSDscoresofanxietyanddepressiondecreasedbyturnsonthefirstweekandthirdmonthaftertreatments.Conclusion:PatientswithOSAHSaremoreanxiousanddepressivethannormal.Compre-hensivenursingcareconducestophysicallyandmentalrehabilitationofOSAHS.Keywords�Depressive,disorder;Sleepapnea-hypopneasyndrome,obstructive;Psychotherapy��阻塞性睡眠呼吸暂停低通气综合征(OSAHS)是目前临床常见疾病,病因主要为上呼吸道解剖狭窄,它以睡眠中异常呼吸事件,低通气、低血氧和睡1中山大学附属第三医院耳鼻咽喉-头颈外科(广州,510630)2哈尔滨医科大学附属第一医院心理科通讯作者:王振霖(Email:wzl1812@yahoo.com.cn)眠结构紊乱为主要表现。通过反复觉醒和睡眠低氧血症和睡眠结构紊乱,发生神经内分泌功能失调及血流动力学异常,导致组织器官缺血、缺氧,多系统器官功能损害,继而引发白天嗜睡和心脑血管病变等一系列躯体疾病�1�。近年来的研究发现其与参考文献1NishijimaT,SakuraiS,AriharaZ,etal.Plasmaorex-in-A-likeimmunoreactivityinpatientswithsleepapneahypopneasyndrome.Peptides,2003,24:407-411.2姚行齐,褚勇,孙艺,等.舌骨悬吊术治疗重度阻塞性睡眠呼吸暂停低通气综合征34例.临床耳鼻咽喉科杂志,2005,19(3):132-133.3熊雯,于常声,周建华.Orexin(hypocretin)研究新进展.医学综述,2002,8(3):565-567.4SakuraiT.Orexinandorexinreceptors:implicationinfeedingbehavior.RegulPept,1999,85:25-30.5KimHY,HongE,NimJI,etal.Solutionstructureofhumanorexin.A:regulatorofappetiteandwakefu-lness.TBiochemMolBiol,2004,37:565-573.6姚行齐,张桂凤,杨长亮,等.阻塞性睡眠呼吸暂停低通气综合征患者手术治疗前后微觉醒的变化及意义.中国医师杂志,2005,7(1):54-55.7IgarashiN,TatsumiK,NakamuraA,etal.Plasmaorexin-Alevelsinobstructivesleepapnea-hypopneasyndrome.Chest,2003,124:1381-1385.8宋承辉,胡志安.Orexin:觉醒通路中一种重要的下丘脑神经肽.第三军医大学学报,2003,25(6):1207-1209.(收稿日期:2005-09-01)�549�临床耳鼻咽喉科杂志2006年6月第20卷第12期心理状况改变相关,并可引起认知等功能受损�2,3�。本文通过对我院2004年8月~2005年2...
