脑卒中后抑郁症112例临床分析

目的对脑卒中后抑郁状态进行临床分析,探索其发生的可能机制及治疗方法。方法对112例脑卒中后患者采用汉密尔顿抑郁量表（HAMD）评分≥17分者确定为抑郁症,将其随机分为治疗组和对照组。治疗组采取常规的脑卒中治疗加氟西汀和心理综合治疗措施,对照组常规的脑卒中治疗,两组在治疗前及治疗第4、8周后分别进行HAMD评分及NIH-NINDS卒中评分判定疗效,观察抑郁症的临床表现和服用氟西汀加心理治疗的治疗效果,分析抑郁症的产生与脑卒中后脑血管损害部位,神经功能缺损程度之间的关系。结果治疗组较对照组治疗前后差异有统计学意义（P〈0.01）。结论对脑卒中后抑郁症患者在积极治疗原发病的同时辅以氟西汀加心理综合治疗有较好的治疗效果。

112 cases clinical analysis of depressive disorder after cerebral apoplexy

Objective It is to explore the probable mechanism and therapy method with clinical analysis on depressive disorder after cerebral apoplexy.Methods 112 cases of patients with cerebral apoplexy were evaluated by HAMD（Hlamilton Depression Scale） score,the cases which the score≥17 were diagnosed to depressive disorder.These cases were randomly divided into two groups.The control group and treatment group were both treated with conventional treatment.And the treatment group was also treated with Fluoxetine and psychological comprehensive therapy.The effects of two groups were evaluated with HAMD and NIH-NINDS score before therapy and in 4 week and 8 weeks.The clinical performance of the patients suffering from depression and the effects of the treatment group were observed.The relationship of depression generation,the damaged location of cerebral vessels after cerebral apoplexy,the defective incomplete of neural function were analyzed.Results There were significant differences in the treatment group and the control group（P0.01） after treatment.Conclusion Adding Fluoxetine and psychological comprehensive therapy can improve therapeutic efficacy of depressive disorder after cerebral apoplexy,on account of treating primary disease positively.