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冠状动脉旁路移植术后患者的术后抑郁——文献综述。

Postoperative depression in patients after coronary artery bypass grafting (CABG) - a review of the literature.

机构信息

Student Research Group of Applied Psychology, Medical University of Lublin.

Student Research Group at the Chair and Department of Epidemiology and Clinical Research Methodology, Medical University of Lublin, Poland.

出版信息

Pol Przegl Chir. 2020 Aug 4;92(6):32-38. doi: 10.5604/01.3001.0014.3431.

Abstract

<b>Introduction:</b> Ischemic heart disease is the most common cause of death in the world. The lives of patients with vascular defects can be saved by coronary artery bypass grafting (CABG). However, it is associated with an increased risk of developing depression after surgery. <br><b>Meterial and Methods:</b> The aim of the study is to present the results of the latest research on postoperative depression after CABG, including studies describing the course of the disease, its consequences for the patient's prognosis and treatment. The publications available on the PubMed platform published after 2011 were reviewed. <br><b>Results:</b> Depression before and after CABG affects 30-40% of patients, mostly women. Established after surgery and untreated, it persists for many years. The level of anxiety in patients decreases systematically after surgery. Indicators that may correlate with the patient's postoperative depression, including cortisol, high sensitivity C-reactive protein (hsCRP) and oxidative stress biomarkers, are being investigated. The occurrence of depression in patients after CABG has a number of negative consequences. Those include: weaker response to treatment, greater chance of relapse, and increased readmission frequency and mortality. Treatment of patients with this disorder involves the use of antidepressants (most often SSRIs - selective serotonin reuptake inhibitor) and/or various types of psychotherapy with cognitive behavioral therapy (CBT) at the forefront. <br><b>Conclusions:</b> Depression following CABG decreases the quality of life and worsens patient prognosis. It is necessary to detect this condition early after surgery and to apply treatment, taking into account the cardiological disorders of the patient.

摘要

<b>引言:</b> 缺血性心脏病是世界上最常见的死亡原因。通过冠状动脉旁路移植术(CABG)可以挽救患有血管缺陷的患者的生命。然而,它与手术后发生抑郁症的风险增加有关。<br><b>材料和方法:</b> 本研究旨在介绍 CABG 后术后抑郁症的最新研究结果,包括描述疾病过程、对患者预后和治疗的影响的研究。回顾了 2011 年后在 PubMed 平台上发表的可用出版物。<br><b>结果:</b> CABG 前后的抑郁症影响 30-40%的患者,大多数为女性。手术后未得到治疗且持续存在多年。手术后患者的焦虑程度会系统地降低。正在研究可能与患者术后抑郁症相关的指标,包括皮质醇、高敏 C 反应蛋白(hsCRP)和氧化应激生物标志物。CABG 后患者发生抑郁症会产生许多负面影响。这些包括:治疗反应减弱、复发机会增加、再次入院频率和死亡率增加。治疗这种疾病的患者包括使用抗抑郁药(最常使用选择性 5-羟色胺再摄取抑制剂(SSRIs))和/或各种类型的认知行为疗法(CBT)心理疗法。<br><b>结论:</b> CABG 后抑郁症降低了生活质量并恶化了患者的预后。有必要在手术后早期发现这种情况,并考虑患者的心脏疾病进行治疗。

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