摘要

【摘要】
目的 探究认知行为疗法（Cognitive Behavioral Therapy，CBT）联合加速康复外科（Enhanced Recovery After Surgery，ERAS）理念对早期脊髓损伤（Spinal Cord Injury，SCI）术后患者抑郁焦虑情绪的影响。

方法 选择SCI患者120例，按随机数表法分为对照、研究组，均60例。对照组行标准化ERAS围术期管理，研究组在此基础上行CBT干预。比较两组症状自评量表（Symptom Checklist 90，SCL-90）、视觉模拟评分法（Visual Analogue Scale，VAS）、匹兹堡睡眠质量指数（Pittsburgh Sleep Quality Index，PSQI）评分。

结果 干预4周后，研究组SCL-90中躯体化、强迫、抑郁、焦虑、精神病性维度分均低于对照组（P＜0.05）。干预2周时，研究组VAS评分低于对照组（P＜0.05）；干预4周时，两组VAS评分均降低（P＜0.05），但两组间比较无差异（P＞0.05）。干预4周后，两组PSQI评分均降低，且研究组更低（P均＜0.05）。

结论 CBT结合ERAS理论用于早期SCI患者可有效缓解焦虑、抑郁等症状，并可降低疼痛，改善睡眠质量。

关键词：【关键词】 认知行为疗法；加速康复外科；脊髓损伤；焦虑；抑郁

ABSTRACT

【Abstract】
Objective To exploring the effect of cognitive behavioral therapy (CBT) combined with Enhanced Recovery After Surgery (ERAS) concept on depression and anxiety in patients with early spinal cord injury (SCI) after surgery.

Methods 120 SCI patients were selected and randomly divided into a control group and a study group, with 60 patients in each group. The control group received standardized ERAS perioperative management, while the study group received CBT intervention on this basis. Compare the Symptom Checklist 90 (SCL-90), Visual Analog Scale (VAS), and Pittsburgh Sleep Quality Index (PSQI) scores between two groups.

Results After 4 weeks of intervention, the scores of somatization, obsessive-compulsive disorder, depression, anxiety, and psychoticism dimensions in the SCL-90 of the study group were lower than those of the control group (P<0.05). After 2 weeks of intervention, the VAS score of the study group was lower than that of the control group (P<0.05); After 4 weeks of intervention, both groups showed a decrease in VAS scores (P<0.05), but there was no significant difference between the two groups (P>0.05). After 4 weeks of intervention, both groups showed a decrease in PSQI scores, with the study group having even lower scores (all P<0.05).

Conclusion   CBT combined with ERAS theory can effectively alleviate symptoms such as anxiety and depression in early SCI patients, reduce pain, and improve sleep quality.

Key words: 【Key words】 Cognitive Behavioral Therapy; Enhanced Recovery After Surgery; Spinal Cord Injury; Anxiety; Depressed