老年脑卒中后抑郁症及神经功能康复的临床治疗

目的：探讨氟西汀对老年脑卒中后抑郁症及神经功能康复的临床效果。方法：回顾分析本院2009年10月至2010年10月收治的80例老年脑卒中患者，随机分为两组，实验组40名，行氟西汀（20mg／d）抗抑郁治疗；对照组40名，行茴拉西坦胶囊（100mg／d）做安慰剂使用。两组均先行神经内科常规和康复治疗，治疗后随访3—6个月，老年脑卒中治疗效果评估采用抑郁状态量表（self-rating depression scale，SDS）评分标准和神经功能缺损评分标准（改良爱丁堡一斯堪的纳维亚卒中量表，Modified Edinburgh scandinavian stroke scale，MESSS）两项进行评定，并对患者日常生活活动能力（activitiesofdailyliving，ADI）分级变化进行统计。结果：随访期间两组患者相比，实验组SDS和MESSS评分均优于对照组，差异有统计学意义（P〈0．05）。两组相比，实验组患者治疗后ADI分级变化优于对照组，差异有统计学意义（P〈0．05）。结论：早期行氟西汀治疗老年脑卒中，可有效减缓患者产生不稳定的抑郁心理，有利于恢复患者缺损的神经功能，显著提高患者的日常生活活动能力，可临床推广使用。

Elderly post-stroke depression and neurological rehabilitation clinical treatment

Objective：To evaluate fluoxetine in elderly post-stroke depression and neurological rehabilitation methods and results,provide a reference for clinical treatment. Methods：A retrospective analysis of our hospital in October 2009 to October 2010 collected 80 cases treated in elderly stroke patients were randomly divided into two groups. Department of Neurology, two groups were first conventional treatment and rehabilitation, and then the experimental group 40, the line fluoxetine （20 mg/d） of antidepressant treatment; the control group 40, the line of aniracetam capsules（ 100 mg/d） to do to comfort agents. Up for 3 months after treatment-6 months, elderly stroke treatment effect was assessed using depression scale （SDS） scoring criteria and standards of neurological deficit score （Modified Edinburgh scandinavian stroke scale, MESSS ） two items were assessed, and patients with activities of daily living（ADI） for statistical classification change. Results：During follow-up compared two groups of patients, the experimental group depression scale （SDS） neurological deficit scoring criteria and scoring （MESSS） are better than the control group, the difference was statistically significant（P 〈 0.05 ）. Compared the two groups, experimental group patients than the control group ADI grade changes,the difference was statistically significant（P 〈 0.05 ）. Conclusion： Fluoxetine treatment of elderly stroke early stage, can effectively reduce depression in patients with unstable generated will help restore neurological function in patients with defects was significantly increased in patients with activities of daily living, should be used widely in clinical.