脑卒中康复期情绪障碍的影响因素分析及心理干预效果观察

目的:分析脑卒中康复期情绪障碍发生的相关因素及心理治疗。方法:对120例脑卒中患者的卒中类型、脑卒中病灶部位、神经功能缺损程度(NIHSS)评分、Barthel指数(BI)、症状自评量表(SCL-90)、汉米尔顿抑郁量表(HAMD)、抑郁自评量表(SDS)、焦虑自评量表(SAS)评分进行记录。按国际疾病分类第10版(ICD-10)的诊断标准分别做出"焦虑障碍(PSAD)"、"抑郁障碍(PSDD)"的诊断。所有患者在康复治疗中,对有PSAD、PSDD的患者给予心理干预。结果:120例脑卒中康复期的患者中情感障碍总共发生68例,其中轻、中度抑郁障碍28例,轻、中度焦虑障碍发生66例。脑卒中后康复患者多易出现情绪障碍,常有抑郁、焦虑、紧张、恐惧、强迫、躯体化症状、人际关系敏感等神经心理学改变。情绪障碍的发生与脑卒中类型、脑卒中病灶部位、入院时NIHSS评分及BI评分有关。伴发抑郁障碍患者通过心理干预,药物治疗,肢体功能的恢复,抑郁状态明显改善。结论:脑卒中后康复患者多易出现情绪障碍,应给予积极地心理干预治疗。

Affecting Factors and Psychological Therapy for Mood Disorders in Stroke Rehabilitation Process

Objective:To analysis the related factors of the mood disorders in the rehabilitative period of stroke and its psychological treatment.Methods:Make a record for 120 stroke patients,including the stroke style,lesion location,NIHSS,BI,SCL-90,HAMD,SDS and SAS.Do the diagnosis of PSAD and PSDD according to the standard in the ICD-10.During the rehabilitative period,do the psychological intervention for the patients with PSAD and PSDD.Results:The incidence of mood disorder is 57%(68/120).The incidence of mild or moderate depressive disorder is 42%(28/68).The incidence of anxiety disorder is 96.70%(66/68).The rehabilitation patients after stroke is easy to appear mood disorder,like depression,anxiety,nervousness,fear,force,somatic symptoms,interpersonal sensitivity and so on.The appearance of mood disorder may relate to Stroke Pattern,lesion location,NIHSS and BI On admission.Through psychological intervention,medical treatment and the limbs functional recovery,the depression state is improved obviously.Conclusion:The rehabilitative patients of stroke easily emerges the mood disorder,should be given positively the psychological intervention.