武汉地区脑卒中急性期患者发生抑郁的危险因素及对策

目的探讨武汉地区脑卒中患者发生抑郁的危险因素及对策分析。方法采用分层整群抽样方式随机抽取2019年6月至2020年6月武汉地区住院的628例脑卒中急性期患者为调查对象,根据HAMD评分分为正常组(n=381)和卒中后抑郁组(n=247),采用自制问卷调查性别、年龄、文化程度、脑卒中类型、居住地、患者对治疗的依从性、NIHSS评分、日常生活能力(ADL评分)、独立行走情况,采用logistic回归分析脑卒中患者发生抑郁的危险因素,并提出早期干预措施。结果单因素分析发现,文化程度、家庭负担、NIHSS评分、ADL评分、独立行走情况与脑卒中患者发生抑郁有关(P<0.05),logistic多因素回归分析显示,NIHSS评分、ADL评分、独立行走情况与脑卒中后急性期患者发生抑郁相关(P<0.05)。结论脑卒中急性期患者发生抑郁的风险较高,其中患者对治疗的依从性、NIHSS评分、ADL评分、独立行走情况是导致脑卒中患者发生抑郁的高危因素,应尽快提高患者对治疗的依从性和日常生活能力,改善神经功能,应重视对其早期干预。

Risk factors and countermeasures of depression in acute stroke patients in Wuhan

Objective To explore the risk factors and countermeasures of depression in stroke patients in Wuhan.Methods A stratified cluster sampling method was used to randomly select 628 hospitalized patients at acute stage of stroke in Wuhan from June 2019 to June 2020.According to HAMD score,the patients were divided into normal group(n=381)and post-stroke depression group(n=247).The risk factors of depression in stroke patients were analyzed by Logistic regression using self-made questionnaire,including gender,age,education level,stroke type,residence,patient compliance to treatment,NIHSS score,ADL score and independent walking,and early intervention measures were proposed.Results Univariate analysis showed that education level,family burden,NIHSS score,ADL score and independent walking were related to the occurrence of depression in stroke patients(P<0.05).Logistic multivariate regression analysis showed that,NIHSS score,ADL score and independent walking were correlated with depression in patients at acute stage after stroke(P<0.05).Conclusion the risk of depression in patients with acute cerebral apoplexy is higher,the patients′adherence to treatment,NIHSS score,ADL scores,situation of independent walking is a cause of depression in patients with cerebral apoplexy risk factors,should improve patients′adherence to treatment as soon as possible and daily life ability,improve nerve function,should pay attention to its early intervention.