无抽搐电休克治疗老年难治性精神分裂症临床研究

目的研究联合无抽搐电休克(MECT)治疗老年难治性精神分裂症急性期及维持期的疗效和安全性。方法对63例老年难治性精神分裂症,在急性期及维持期联合MECT治疗,用PANSS量表评定疗效,用TESS评定不良反应,用WMS进行记忆测定。结果 MECT急性期治疗后43例(68.3%)有效,急性期治疗结束后,(PANSS)阴性与阳性症状量表总分、阳性症状、阴性症状、一般精神病理评分的下降有非常显著性差异(t=3.45～8.36,P<0.01);维持治疗8周末、维持治疗16周末与治疗前比较,PANSS量表总分、阳性症状、阴性症状、一般精神病理评分的下降均有非常显著性差异(t=5.04～11.33,P<0.01)。韦氏记忆量表(WMS)评分中的再认(t=5.13)、图片(4.48)、联想(3.25)及背数(3.15)在急性期治疗结束后1d较治疗前评分下降有非常显著性差异,但在维持治疗前1d、维持治疗8周末、维持治疗16周末、维持治疗18周末较治疗前评分无显著性差异(P>0.05)。无明显不良反应。结论 MECT安全性高,适于老年人,对老年难治性精神分裂症的急性和维持治疗均有效。

Efficacy of Modified Electroconvulsive Therapy in Treatment of Geriatric Refractory Schizophrenia

Objective To explore the efficacy and safety of combining acute and maintenance MECT for the geriatric refractory schizophrenia.Methods A total of 63 geriatric refractory schizophrenias in were treated with combining acute and maintenance MECT.The effects were evaluated by the PANSS and the side effect by TESS.The memory measurement was evaluated by WMS.Results 43（68.3%）patients were effective at the end of acute MECT.Comparing in the end with before acute MECT,the total score of PANSS,the scores of positive symptom,the scores of negative symptom and general psychopathology reduced significantly（t=3.45~8.36,P0.01）.Comparing the end of 8-week and 16-week in maintenance MECT with the before of acute MECT,the total score of PANSS,the scores of positive symptom,the scores of negative symptom and general psychopathology reduced significantly（t=5.04~11.33,P0.01）.The scores of recognition（t=5.13,P0.01）,the scores of picture（t=4.48,P0.01）,the scores of association（t=3.25,P0.01）,the scores of number recite（t=3.15,P0.01）decreased significantly at 1 day after the endpoint of MECT,but there was no significant difference between before and 1 day before the maintenance MECT and the end of 8,16,18-week in maintenance MECT（P0.05）.There was no significant side effects.Conclusion MECT is a safe way for geriatric refractory schizophrenia.Combining MECT may be effective for the geriatric refractory schizophrenia not only in acute but also in maintenance therapy.