早期心理干预对急性脑卒中抑郁患者的近期效果  

Recent effects of early psychological intervention for patients with post-stroke depression

作　　者：关文标[1] 高德九[1] 李安民[1] 欧阳升[1] 戴志成[1] 

机构地区：[1]兰州医学院附属白银医院神经内科,甘肃省白银市730900

出　　处：《中国临床康复》2004年第31期6832-6833,共2页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:评价早期心理干预对急性脑卒中后抑郁患者前3个月的抑郁障碍和日常生活活动能力的改善作用。方法:选择兰州医学院附属白银医院神经内科86例急性脑卒中后抑郁患者犤汉密顿抑郁量表(HAMD)评分在8分以上犦,随机分为研究组、对照组各43例,两组在实验过程中因失访和依从性差退出11例,死亡2例,进入结果分析研究组38例,对照组35例。对照组采用一般常规治疗,研究组除常规治疗外,在发病2周内采取心理干预。在治疗前和治疗后1个月末、3个月末采用HAMD和日常生活活动量表对疗效分别进行评价。结果:治疗后1个月末HAMD评分研究组为(12.18±2.39)分,对照组为(17.25±3.64)分,两组比较差异有显著性意义(t=-3.58,P<0.05),ADL评分差异无显著性意义(P>0.05);治疗后3个月末HAMD评分研究组为(6.35±2.86)分,对照组为(12.68±2.43)分,两组比较差异有显著性意义(t=-4.32,P<0.05),ADL评分研究组为(78.26±13.49)分,对照组为(63.48±10.95)分,两组比较差异有显著性意义(t=6.49,P<0.05)。结论:对急性脑卒中后抑郁患者进行早期心理干预,不仅能够改善患者的抑郁心态,减轻神经功能缺损,提高生活质量,而且无明显副作用,是一种安全有效的治疗方法。AIM:To evaluate the effect of early psychological intervention in improving the depressive disorder and activities of daily living(ADL) in patients with acut post-stroke depression(APSD) during the first 3 months. METHODS:A total of 86 patients with APSD[Hamilton depressive scale(HAMD) was above 8] in the Department of Neurology,Baiyin Hospital of Lanzhou Medical College,were randomly divided into study group(n=43) and control group(n=43).During the study,11 cases exited for lost to the follow up and bad compliance,and 2 cases died,so there were 38 cases in the study group and 35 cases in the control group at last.All the patients received general routine treatment,and besides,those in the study group received psychological intervention within two weeks after attack.HAMD and ADL scale were used to evaluate the curative effect before,1 and 3 months after treatment. RESULTS:One month after treatment,the score of HAMD in the study group was 12.18±2.39,significantly different from that in the control group(17.25±3.64)(t=-3.58,P< 0.05),but there was no significant difference in the score of ADL(P >0.05).Three months after treatment,the score of HAMD in the study group(6.35±2.86) was significantly different from that in the control group(12.68±2.43)(t=-4.32,P< 0.05),and there was also significant difference in the score of ADL between the study group(78.26±13.49) and control group(63.48±10.95)(t=6.49,P< 0.05). CONCLUSION:Early psychological intervention can not only ameliorate the depression,relieve neurologic impairment and improve the quality of life for the patients with acute post-stroke depression,but also results in insignificant side effects,which is an effective and safe therapeutic method.

关 键 词：对照组 患者 急性脑卒中 HAMD 早期心理干预 治疗后 抑郁 显著性 实验过程 意义 

分 类 号：R743[医药卫生—神经病学与精神病学] R544.1[医药卫生—临床医学]