药物干预改善术后抑郁症状的临床研究  

Clinical study on effect of drug intervention on the depression after operation

作　　者：单会莲[1] 张显茹[1] 

机构地区：[1]中国医科大学附属盛京医院第十普通外科,沈阳110020

出　　处：《实用药物与临床》2015年第9期1065-1069,共5页Practical Pharmacy and Clinical Remedies

摘　　要：目的 了解术后抑郁症状发生情况及影响因素,比较不同的药物干预治疗术后抑郁症状的疗效. 方法 调查263例纳入患者的住院资料,进行抑郁评估以及对医护人员的满意度调查;将肯定有抑郁症状的患者随机分为盐酸氟西汀组、米氮平组、联合组和对照组,疗程为2 ～3 个月. 结果 术后抑郁症状的发生率为42. 6%;术后抑郁症状好发于女性（r= -0.154,P=0.013）、18～45岁（r= -0.134,P=0.030）、术后病理为恶性（r= -0.248,P〈0.001）、伴有术后疼痛（r= -0.629,P=0.027）、术后感染（r= -0.480,P〈0.001）、少陪护（r=0.560,P〈0.001）、对医护人员满意度差（r= -0.554,P〈0.001）的患者,与手术部位无关（P〉0.05）;盐酸氟西汀组、米氮平组和联合组用药后抑郁评分均下降（ P均〈0.001 ） ,联合组下降程度高于单药组（ P均〈0.05 ）. 结论 对于术后易发生抑郁症状的患者,合理的药物干预是必要的;盐酸氟西汀联合米氮平治疗术后存在抑郁症状的患者的疗效较好,不良反应较轻,值得临床推广应用.Objective To investigate the incidence and related factors of depression after operation,and com-pare the efficacy on depression after operation improved by different drugs. Methods 263 cases were conducted by hospitalization data survey, depression evaluation and medical staff satisfaction survey. Depression patients were ran-domly divided into fluoxetine group,mirtazapine group,combined group and control group,and the course of treatment＆amp;nbsp;lasted for 2～3 months. Results The incidence of depression after operation was 42. 6%;depression after operation of-ten occurred in female （r= -0.154,P=0.013）,18～45 years old （r= -0.134,P=0.030）,malignant tumor （r= -0.248,P〈0.001） postoperative pain（r= -0.629,P=0.027）,postoperative infection（r= -0.480,P〈0.001）,less accompany （r=0.560,P〈0.001）,lower medical staff satisfaction （r= -0.554,P〈0.001）,and it had nothing to do with the operation site （P〉0.05）. Depression scores of fluoxetine group,mirtazapine group and combined group all decreased after treatment （P〈0.001）,and combined group decreased more obviously than the single drug groups（P〈0.05）. Conclusion For the patients prone to depression after operation,reasonable drug intervention is necessary;and the curative efficacy of fluoxetine combined with mirtazapine on depression after operation is better than that of single drug,and the adverse reactions are mild,it is worthy of clinical application.

关 键 词：术后抑郁 相关因素分析 米氮平 盐酸氟西汀 

分 类 号：R619[医药卫生—外科学] R749.4[医药卫生—临床医学]