半结构化心理干预联合重复经颅磁刺激治疗脑卒中后抑郁患者的临床观察  

Clinical study of semi-structured psychological intervention combined with repetitive transcranial magnetic stimulation in the treatment of post-stroke depression

作　　者：李霞[1] 董丽丽[1] 周明[1] 张佳丽[1] 王宁[1] 赵克佳 周莹[1] 王刚[1] 李军[1] 黄丽萍[1] Li Xia;Dong Lili;Zhou Ming(Department of Rehabilitation Medicine,the First Centre,Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]解放军总医院第一医学中心康复医学科,北京100853

出　　处：《中华保健医学杂志》2023年第2期212-214,共3页Chinese Journal of Health Care and Medicine

基　　金：解放军总医院医学工程实验室自主科研项目(2022SYSZZKY14)。

摘　　要：目的观察半结构化心理干预联合重复经颅磁刺激(rTMS)对脑卒中后抑郁患者的效果影响。方法前瞻性选取2018年5月~2021年5月于解放军总医院第一医学中心收治的124例脑卒中后抑郁患者,根据随机数表法将患者分为对照组和观察组,各62例。对照组给予常规干预+rTMS,观察组则在对照组基础上给予半结构化心理干预。根据汉密顿抑郁量表评价疗效,采用美国国立卫生研究院卒中量表(NIHSS)评分评价神经功能,Barthel指数(BI)评分评价生活自理能力。并统计治疗过程中不良反应发生率。结果治疗后两组HAMD、NIHSS评分均低于治疗前,Barthel指数(BI)评分均高于治疗前;且观察组HAMD、NIHSS评分低于对照组,Barthel指数(BI)评分高于对照组,差异有统计学意义(P<0.05)。观察组总有效率为91.94%(57/62),高于对照组的总有效率79.03%(49/62),差异有统计学意义(P<0.05)。观察组不良反应发生率为1.61%(1/62),与对照组不良反应发生率3.23%(2/62)相比,差异无统计学意义(P>0.05)。结论半结构化心理干预联合r TMS治疗脑卒中后抑郁患者,可有效缓解患者抑郁情绪,改善神经功能和提高日常生活能力。Objective To observe the effect of semi-structured psychological intervention combined with repetitive transcranial magnetic stimulation(rTMS)on post-stroke depression patients.Methods A total of 124 patients with post-stroke depression who were treated in our hospital from May 2018 to May 2021 were selected as the research objects,and they were randomly divided into a control group of 62 cases and an observation group of 62 cases.The control group was given routine intervention+rTMS,while the observation group was given semi-structured psychological intervention on the basis of the control group.The efficacy and HAMD-17 scores of the two groups were recorded,and the differences in National Institutes of Health Stroke Scale(NIHSS)scores,self-care ability scores and adverse reactions between the two groups were recorded.Results After semi-structured psychological intervention combined with rTMS intervention,the HAMD-17 scores of the observation group was lower than those in the control group and HAMD-17 scores of the two groups were lower than those before treatment(P<0.05).The total effective rate in the observation group was 91.94%(57/62),which was higher than that in the control group,which was 79.03(49/62),with statistical significance(P<0.05).After intervention,the NIHSS scores of the observation group was lower than those in the control group and NIHSS scores of the two groups were lower than those before treatment(P<0.05).however,After intervention,the BI scores of the observation group was higher than those in the control group and BI scores of the two groups were higher than those before treatment(P<0.05).The adverse reaction rate in the observation group was 1.61%(1/62)compared with 3.23%(2/62)in the control group,which was not statistically significant(P>0.05).Conclusion Semi-structured psychological intervention combined with rTMS in the treatment of post-stroke depression can effectively relieve depression,improve neurological function and daily living ability.

关 键 词：半结构化心理 重复经颅磁刺激 脑卒中 抑郁 

分 类 号：R735[医药卫生—肿瘤]