高频重复经颅磁刺激联合心理干预对产后抑郁自杀意念的影响  

Effects of high frequency repetitive trans-skull magnetic stimulation combined with psychological intervention on suicidal ideation of patients with postpartum depression

作　　者：娄凤艳 杨树磊 李德海[1] 陈倩倩 LOU Fengyan;YANG Shulei;LI Dehai(Nursing Department,Jiulong Mountain Hospital, Qinhuangdao City,Hebei,Qinhuangdao 066000,China)

机构地区：[1]河北省秦皇岛市九龙山医院护理部,066000

出　　处：《河北医药》2020年第8期1266-1269,共4页Hebei Medical Journal

基　　金：秦皇岛市科学技术项目(编号:201805A124)。

摘　　要：目的本研究主要探讨高频重复经颅磁刺激(repetitive transcranial magnetic stimulation,rTMS)联合心理干预对产后抑郁患者自杀意念的影响及安全性。方法选取60例伴有自杀意念的产后抑郁症患者,随机分配中途退出研究4例,研究组和对照组,每组28例。研究组采取高频rTMS联合心理治疗对受试者进行干预,其中rTMS刺激频率为10 Hz,刺激部位为左侧前额叶背外侧皮质(dorsolateral prefrontal cortex,DLPFC);心理干预采用的是认知行为治疗(cognitive-behavioral therapy,CBT),1次/周,共计4周。对照组采用rTMS伪刺激联合心理干预。分别于基线期、治疗2周、4周后采用汉密尔顿抑郁量表(HAMD)和自杀意念自评量表(SIOSS)对治疗效果进行评分,并进行疗效评价。结果2组治疗后HAMD评分及SIOSS评分均低于治疗前(P<0.05);研究组治疗后HAMD评分及SIOSS评分均低于对照组(P<0.05)。研究组在治疗2周后显效率以及4周后的有效率高于对照组,差异有统计学意义(P<0.05)。结论rTMS刺激联合心理干预能能减轻产后抑郁症患者的自杀意念,降低自杀风险,且安全性好。Objective To investigate the effects and safety of high frequency repetitive trans-skull magnetic stimulation(rTMS)combined with psychological intervention on suicidal ideation of patients with postpartum depression.Methods Thirty patients with postpartum depression and suicidal ideation were randomly divided into research group and control group,with 28 cases in each group due to dropout of 4 cases.The patients in research group were intervened by high frequency rTMS combined with psychotherapy,however,the patients in control group were treated by rTMS pseudo-stimulation combined with psychological intervention.All the subjects received the same antidepressant dose during the treatment,who agreed to participate in the study and signed the informed consent.After 2-week and 4-week treatment,the therapeutic effects were evaluated by using Hamilton Depression Rating Scale(HAMD)and Suicidal Thought Self-Assessment Scale(SIOSS)at baseline.Moreover the TESS side-effect scale was used to evaluate the adverse reactions of the subjects.Results Before treatment there were no significant differences in patient’s age,ethnicity,occupation,education levels,HAMD and SIOSS scores between the two groups(P>0.05).After treatment the HAMD scores and SIOSS scores in both groups were significantly decreased(P<0.05),moreover,which in research group were significantly lower than those in control group(P<0.05).In addition the excellent effective rate after 2-week treatment and the effective rate after 4-week in research group were significantly higher than those in control group(P<0.05).Conclusion The rTMS stimulation combined with psychological intervention can relieve the suicidal ideation in patients with postpartum depression,and reduce suicide risk,with better safety.

关 键 词：重复经颅磁刺激 心理干预 产后抑郁 自杀意念 安全性 

分 类 号：R473.71[医药卫生—护理学]