急性脑卒中后吞咽障碍患者焦虑抑郁状态调查和对分析  

The investigation and analysis of anxious and depressive in dysphagic stroke patients

作　　者：孙漓[1] 朱治山[1] 郭瑾[1] 

机构地区：[1]深圳市第五人民医院,广东深圳518001

出　　处：《临床医药实践》2008年第S4期848-850,共3页Proceeding of Clinical Medicine

摘　　要：目的:探讨脑卒中后吞咽障碍患者焦虑及抑郁情绪的变化及其对吞咽功能康复的影响,研究汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)在脑卒中后吞咽障碍患者诊治中的应用价值。方法:对60例脑卒中后吞咽障碍患者进行HAMA和HAMD评分,以健康人和脑卒中后无吞咽障碍患者为对照,比较三组的评分差别;脑卒中后吞咽障碍患者根据HAMA和HAMD评分分为焦虑/抑郁组和非焦虑/抑郁组,比较两组吞咽康复疗效的差别。结果:健康人与脑卒中后吞咽障碍患者的HAMA、HAMD评分有显著性差异;脑卒中对照组患者与脑卒中后吞咽障碍患者HAMA、HAMD评分无显著性差异;其中28例焦虑/抑郁组患者吞咽康复有效15例(53.5%)、显效4例(14.3%)、总有效率67.8%,非焦虑/抑郁组32例患者的吞咽康复吞咽康复有效17例(53.1%)、显效10例(31.3%)、总有效率84.4%,两组总有效率比较有显著性差异。结论:脑卒中后吞咽障碍患者焦虑和抑郁状况较普遍,且该情绪影响吞咽功能康复的疗效;HAMA和HAMD可用于判断脑卒中后吞咽困难病人焦虑抑郁情况,指导治疗。Objective:To investigate the alteration of anxiety and depression in dysphagic stroke patients and the effect on the swallow rehabilitation.To study the value of Hamilton anxiety scale(HAMA)and Hamilton depression scale(HAMD) on the diagnosis and therapy in dysphagic stroke patients.Method:The healthy adults,the stroke patients without dysphagia and the dysphagic stroke patients were assessed with HAMA and HAMD,to analyze the difference of scores between them.According to the scores of HAMA and HAMD,60 dysphagic stroke patients were divided into two groups,one group with anxiety or depression,the other group without anxiety and depression.The swallow rehabilitation effects were observed and analyzed.Results:There was significant difference in scores of HAMA and HAMD between healthy adults and dysphagic stroke patients.There was not significant difference between the stroke patients without dysphagia and the dysphagic stroke patients.For patients in group with anxiety or depression,15 cases was partially cured,4 cases was completely cured,recovery rate of rehabilitation was 67.8%.For patients in group without anxiety and depression,17 cases was partially cured,10 cases was completely cured,recovery rate of rehabilitation was 67.8%.There was a significant difference between the two groups.Conclusion:The anxiety and depression,which are common in the dysphagic stroke patients,will affect significantly swallow function rehabilition.The Scales used in this study can be applied to the judgement of patients′ anxiety and depression,and a guide to therapy.

关 键 词：脑卒中 吞咽障碍 汉密尔顿焦虑量表 汉密尔顿抑郁量表 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R749.1[医药卫生—临床医学]