综合性心理干预对脑卒中伴抑郁和焦虑患者神经和认知功能的影响  

The effect of comprehensive mental intervention on nerve and cognitive function of stroke patients combined with depression and anxiety

作　　者：王锦芬[1] 方志红 

机构地区：[1]浙江省台州市第二人民医院心身科,浙江台州317200 [2]浙江省台州市恩泽医疗中心(集团)内科,浙江台州318050

出　　处：《中国医药导报》2013年第23期144-146,共3页China Medical Herald

基　　金：浙江省医药卫生科技计划项目(编号2011ZHA011)

摘　　要：目的探讨综合性心理干预对脑卒中伴抑郁和焦虑患者神经和认知功能的影响。方法 80例在浙江省台州市第二人民医院、浙江省台州市恩泽医疗中心(集团)内科住院的脑卒中伴抑郁和焦虑患者,随机分为观察组和对照组。两组患者均予以控制颅内压、血压和血糖、营养脑细胞及改善脑循环等治疗,观察组在此基础上予以综合性心理干预治疗,两组疗程均为4周。结果治疗4周后,两组患者HAMD和HAMA评分均有明显下降(对照组治疗前后,t=2.23、2.31,P<0.05,观察组治疗前后,t=3.02、3.26,P<0.01),且观察组下降值较对照组更明显(t=2.29、2.33,P<0.05);两组患者CNS评分均有明显下降,FMA评分均有明显上升(对照组治疗前后,t=2.21、2.29,P<0.05;观察组治疗前后,t=3.41、2.91,P<0.01),且观察组下降或上升值较对照组更明显(t=2.39、2.21,P<0.05);观察组患者认知功能改善总有效率(87.5%)明显优于对照组(62.5%)(χ2=7.41,P<0.01)。结论综合性心理干预能明显改善脑卒中伴抑郁和焦虑患者心理状态,有利于患者神经和肢体运动功能的尽早恢复,促进患者认知功能障碍的有效恢复,提高了患者的生活质量与预后。Objective To explore the effect of comprehensive mental intervention on neural function and cognitive function of stroke patients combined with depression and anxiety.Method 80 stroke patients combined with depression and anxiety in Department of Medicine of the Second People′s Hospital of Taizhou City and Enze Medical Center of Taizhou were randomly divided into observing group and control group.All the patients got treatment as intracra nial-pressure,blood-sugar and blood-pressure control,brain-cell-nurturing,and cerebral-circulation-improving.And patients of observing group got extra comprehensive mental intervention.The treatment lasted for 4 weeks.Results 4 weeks after treatment,the scores of HAMD and HAMA both descended in both the two groups（before and after treat ment in control group,t = 2.23,2.31,P 0.05;before and after treatment in observing group,t = 3.02,3.26,P 0.01）.And the range of decline of observing group was significantly more obviously than that of control group（t = 2.29,2.33,P 0.05）.The score of CNS descended in both the two groups,but the score of FMA was the opposite（before and after treatment in control group,t = 2.21,2.29,P 0.05;before and after treatment in observing group,t = 3.41,2.91,P 0.01）,and the range of change of observing group was significantly more obviously than that of control group（t = 2.39,2.21,P 0.05）.The total effective rate（87.5%） of improvement of cognitive function of observing groups was higher than that（62.5%） of control group（χ2 =7.41,P 0.01）.Conclusion Treating stroke patients combined with depression and anxiety by comprehensive mental intervention can improve the psychological states,shorten the recovery time of neural function and motor function of limbs,promote the recovery of the cognitive function and improve the quality of life and prognosis of the patients.

关 键 词：脑卒中 抑郁 焦虑 心理干预 

分 类 号：R743.3[医药卫生—神经病学与精神病学]