老年脑卒中后抑郁症及神经功能康复的临床治疗探讨

目的：探讨氟西汀治疗老年脑卒中后抑郁症患者的临床效果及其对患者神经功能康复的作用。方法：将120例经CT或头部MRI确诊为脑卒中且合并抑郁症的老年患者随机分为观察组以及对照组各60例，其中对照组患者采用常规神经系统药物支持治疗，观察组在对照组的基础上应用氟西汀治疗，持续治疗3个月。对患者随访6个月，观察2组抑郁症状、神经功能及肢体运动功能康复情况。结果：与治疗前相比，观察组治疗后SAS、SDS评分显著下降（ P＜0．05），而对照组治疗前后SAS、SDS评分无变化（ P＞0．05）。与对照组相比，观察组患者治疗后第1个月、2个月、3个月、6个月Barthel指数评分显著优于对照组，差异有统计学意义（P＜0．05）。与对照组相比，观察组患者干预后第1个月、2个月、3个月、6个月神经功能缺损评分（MESSS）显著优于对照组，差异有统计学意义（P＜0．05）。结论：对老年脑卒中后抑郁症患者应用氟西汀治疗能有效改善患者抑郁症状，提高患者生活能力，促进神经功能康复，有利于患者预后。

Clinical study on elderly depression after stroke and neurological rehabilitation

Objective：To investigate fluoxetine treatment of elderly patients with post -stroke depression and its impact on clinical out-comes in patients with neurological rehabilitation role .Methods：120 patients with CT or head MRI diagnosis of stroke and was associated with depression in elderly patients were randomly divided into two groups and the control group of 60 cases , in which the control group were treated with conventional nervous system drugs and supportive treatment were observed in the control group group on the basis of ap -plication of fluoxetine treatment , continuous treatment for 3 months .Patients were followed for six months , depressive symptoms were ob-served , nerve function and motor function recovery situation .Results：Compared with before treatment , after treatment , the observation group SAS, SDS scores were significantly decreased （P 〈0.05）, while the control group before and after treatment SAS , SDS score did not change （P〉0.05）.Compared with the control group , the observation group patients after the first one month , two months, three months, six months Barthel Index scores were significantly better than the control group , the difference was statistically significant （ P 〈0.05）.Compared with the control group , patients in observation group after intervention a month , two months, three months, six months neurological deficit score （MESSS） was significantly better than the control group , the difference was statistically significant （P 〈0.05）. Conclusion：Elderly patients with post -stroke depression fluoxetine treatment could effectively improve depressive symptoms in patients , improve patient life skills , promote neurological rehabilitation , might be conducive to the prognosis of patients .