早期心理干预联合氟西汀治疗脑卒中后抑郁症的临床观察

目的:评价急性脑卒中后抑郁的发生情况,并观察早期心理干预联合氟西汀治疗脑卒中后抑郁症的疗效。方法:220例首发急性脑卒中患者用Hamilton抑郁量表、抑郁自评量表和社会支持量表进行抑郁症评价,并进行Logistic多元逐步回归分析。将确诊为抑郁症的118例患者随机分为对照组和心理干预联合氟西汀治疗组,2组均接受常规药物治疗,治疗组在对照组基础上同步进行心理干预联合氟西汀治疗。结果:脑卒中后抑郁的发生率为53.63%;病灶位于皮质和皮质前部的患者抑郁评分显著高于位于皮质下和皮质后部的患者;治疗后治疗组有效率为93.22%,显著高于对照组的61·01%(P<0·05)。结论:首发急性脑卒中的抑郁症发生率较高,其严重程度与病变部位有关。早期心理干预联合氟西汀治疗脑卒中后抑郁症明显有效。

Early Mental Intervention Plus Fluoxetine for Poststroke Depression

OBJECTIVE: To evaluate the occurrence of poststroke depression and to observe the efficacy of early mental intervention in combination with fluoxetine for poststroke depression. METHODS: The depression of 220 patients with initial acute stroke were evaluated with hamilton depression scale, self-rating depressive scale (SDS), and social support rating scale, and multiple logistic stepwise regression analysis was conducted. A total of 118 cases with the final diagnose of depressive orders were randomly divided into two groups: the control group was treated with conventional drug therapy, while the treat group was treated additionally with mental intervention plus fluoxetine besides the conventional drugs. RESULTS: The incidence of poststroke depression was 58.18%;Those patients whose lesions located at cortices and the anterior cortices significantly achieved higher scores than those whose lesions located at subcortices and the posterior cortices. The effective rate after treatment was significantly higher in the treatment group (93.22%) than in the control group (61.01%)(P<0.05). CONCLUSIONS: The incidence of depression was high in patients with initial acute stroke, with its severity associated with the region of lesion. Early mental intervention in combination with fluoxetine exhibits good outcome for poststroke depression.