综合护理干预对脑卒中后抑郁患者的影响

目的探讨综合护理干预对脑卒中后抑郁（PSD）的影响。方法将66例PSD患者随机分为治疗组和对照组各33例，对照组进行常规抗抑郁治疗和护理，干预组在此基础上实施综合护理干预措施。两组干预前后进行汉密尔顿抑郁量表（HAMD）评分，改良Barthel指数（MBI）评分和护理效果比较。结果两组患者实施干预前HAMD、MBI评分差异无统计学意义（t=1．07，0．24；P〉0．05）。护理干预后1，2，3个月HAMD评分干预组分别为（21．7±3．3），（18．6±3．7），（13．2±3．5）分，均低于对照组评分（31．5±5．4），（27．3±5．1），（22．3±4．1）分，差异具有统计学意义（t=8．90，7．93，9．70；P〈0．01）；MBI干预前、干预后1个月两组比较差异无统计学意义（P〉0．05）；干预后2，3个月干预组分别为（51．3±14．7），（67．3±15．6）分，均高于对照组评分（42．2±12．8），（43．2±13．5）分，差异具有统计学意义（t=2．68，6．71；P〈0．01）。患者临床疗效干预组总有效率为78．78％，对照组为51．51％，差异有统计学意义（x2=5．405，P〈0．05）。结论综合护理干预措施可以减轻PSD患者症状，有利于治疗与护理方案的实施，恢复患者的生活自理能力。

Effect of comprehensive nursing in~rvention on post-stroke depression

Objective To observe clinical effect of nursing intervention on post-stroke depression.Methods 66 cases of post-stroke depression (PSD) were randomly divided into intervention group and control group,33 cases in each group.All patients received antidepressant treatment of common neurology,the control group was given conventional care and life care,the intervention group was given comprehensive nursing interventions.HAMD score,and improved Barthel Index (MBI) were used to evaluate the intervention effect,and the effects were compared between the two groups.Results The HAMD score and MBIindex in two groups do not reach statistical significance ( t =1.07,0.24; P ＞ 0.05 ) before intervention.HAMD scores in intervention group were (21.7 ± 3.3 ),( 18.6 ± 3.7 ) and ( 13.2 ± 3.5 ) after one,two and three months respectively,and those were (31.5 ±5.4),(27.3 ±5.1),(22.3 ±4.1) in control group,and the difference was statistically significant (t =8.90,7.93,9.70; P ＜ 0.01 ).MBI index was the same before intervention and one month after intervention ( P ＞ 0.05 ) ; two and three months after intervention,the MBI index in intervention group were (51.3 ± 14.7),and (67.3 ± 15.6),and was higher than those in control group (42.2 ± 12.8 )and (43.2 ± 13.5); respectively (t =2.68,6.71 ;P ＜ 0.01 ).The total effective rate of intervention group (78.78％) was higher than control group (51.51％ ),and the difference remarkable (x2 =5.405,P ＜ 0.05).Conclusions Comprehensive nursing intervention can reduce symptoms of depression,and is benefit for treatment and care programs implementation,and could resume their self-care ability.