急性脑卒中患者发病后心理状态特征

背景以往对脑卒中以局灶性神经功能缺损为主的躯体症状重视,而对伴有的心理症状容易忽视.目的探讨急性脑血管病患者发病中心理社会因素及病后心理状态.设计以患者和健康人为研究对象,观察性的病例对照研究.单位一所大学医院的神经科.对象2001-01/2003-12绍兴文理学院医学院附属医院神经科住院脑卒中患者55例和健康体检者35例(对照组).方法经CT/MR证实的急性脑血管病患者和对照组在起病1个月内接受症状自评量表(SCL-90)测查.主要观察指标两组对象的SCL-90评分.结果显示急性脑血管病患者心理健康状况较对照组差(P＜0.01),存在着明显的身心反应.进行亚组分析时发现,病灶大小及部位与脑卒中后精神障碍轻重程度有关;左侧大脑半球病变易发生精神障碍.结论心理干预在急性脑血管病防治中是必要的,认识脑卒中对精神活动的不良影响,有助于指导治疗.

Characteristics of the mental state in patients after acute stroke

BACKGROUND: In the past, much attention was paid mainly to the body symptoms like focal neurological impairment in stroke, but the accompanied psychological symptoms were ignored easily.OBJECTIVE: To investigate the psychosocial factor in acute cerebrovascular disease and the mental state after the attack.DESIGN: Observational case-control study based on patients and healthy people.SETTING: A neurology department in a university hospital.PARTICIPANTS: Totally 55 patients with stroke hospitalized in Neurology Department of Hospital Affiliated to Medical College of Shaoxing Art and Science College and 35 healthy people taking physical examination from January 2001 to December 2003 in the hospital as controls.METHODS: Patients with acute cerebrovascular disease certified by CT/MR and people in control group took symptoms checklist-90(SCL-90) test within a month after attack.MAIN OUTCOME MEASURES: SCL-90 scores of the two groups.RESULTS: The condition of mental state in patients with acute cerebrovascular disease was worse than that in control group( P ＜ 0.01 ). There existed obvious physical and mental reaction. It was found in subsection analysis that the size and location of the focus had relationship with the degree of mental disorder after attack and it was easier to have mental disorder if the affection lied in left cerebral hemisphere.CONCLUSION: It is necessary to give psychological intervention in prevention and cure of acute cerebrovascular disease. Recognizing bad effect of stroke on psychoactivity may help to guide the treatment.