脑卒中后抑郁早期综合干预的随访研究

目的:探讨早期综合干预对卒中后抑郁症状的疗效及对功能恢复的影响.方法:采用多种量表评分对114例卒中后抑郁患者进行随机、对照并随访1年的前瞻性研究.结果:研究组与对照组各57例全部完成随访.汉密尔顿抑郁量表17项分在干预后5周,卒中后3、6、12个月研究组均明显优于对照组(P<0.001).抑郁症状在研究组治愈51例(89.5%)、有效57例(100%),对照组分别为2例(3.5%)、7例(12.3%),两组相比差异显著(P<0.001).巴氏指数在干预后各时点研究组均优于对照组(P<0.05).神经功能缺损量表分在干预后5周研究组(7.01±5.43)优于对照组(10.63±8.52,P<0.05),卒中后3、6、12个月两组无显著差异.结论:早期综合干预对卒中后抑郁具有很好的疗效,在一定程度上可加快卒中后神经功能的恢复,提高患者的日常活动能力.

Early Comprehensive Intervention on Post-Stroke Depression

Objective:To investigate therapeutic effects of early onset of comprehensive intervention (psychotherapy plus antidepressant) in treatment of depression after stroke and its effect on functional outcome.Methods:A controlled prospective design was applied in this study of 114 patients with depression after stroke. Several scales were used for functional measure.Results:All cases were observed. 57 patients (study group) received comprehensive therapy and routine treatment of post stroke, 57patients (control) received routine only. At the 5th week after treatment and 3,6 or 12 months after stroke, study group were significantly shown more effective than control group by reduction in 17-item Hamilton Depression Rating Scales (HAMD-17) and by increased Barthel Index (BI).The study group had significant differences than control group by reduction in Neurological Functional Deficit Scores (NFDS) at the 5th week after therapy. In all patients'NFDS, there was no difference between study group and control group at 3,6 or 12 months after stroke. In study group, the effective rate of antidepressant therapy was 100% and the cure rate was 89.5%. These results were significantly better than the counter parts of control group (12.3% and 3.5% respectively, P<0.001).Conclusions:Early onset of comprehensive intervention has good efficacy in post-stroke depression.