脑卒中后抑郁早期干预对神经功能康复的影响

目的对脑卒中后抑郁（Post～stroke Depression，PSD）患者进行早期干预，观察对神经功能康复的影响。方法将66例2008年6月至2009年6月商丘市第一人民医院收治的脑卒中后抑郁患者按患者意愿分成治疗组36例，对照组30例。全部病例均进行常规药物治疗和康复训练。抗抑郁组加用氟西汀20mg口服，1次／d，共4周。所有患者在治疗前及治疗4周后应用汉密顿抑郁量表评估抑郁、应用Baahel指数评估日常生活活动能力，用神经功能缺损程度评分测评神经功能缺损程度。结果治疗组总有效率83％（30／36），对照组为73％（22／30），两组比较差异有显著性意义（P〈0．01），治疗组4周后神经功能缺损评分较对照组有明显改善（P〈0．01），治疗组4周后汉密尔顿抑郁量表（Hamiltion depressionscale，HAMD）≥17分者为2例，抑郁发生率为5％（2／36），对照组4周后HAMD≥17分者6例，抑郁发生率为20％（6／30），差异亦有显著性意义（P〈0．01），治疗组未发现明显不良反应。结论早期干预能显著改善急性脑卒中后抑郁患者的抑郁症状，促进日常生活活动能力和神经功能的恢复。

Post-stroke depression early intervention on neurological rehabilitation

Objective Depression after stroke in patients with early intervention,observation of the neurological rehabilitation.Methods 66 patients in June 2008 ～ 2009 Shangqiu City in June admitted the First People's Hospital,patients with depression according to the wishes of patients divided into treatment group 36 cases ,30 cases of the control group.All cases were routine drug treatment and rehabilitation training.Antidepressant group were treated with fluoxetine 2 0 mg orally,1 time/d,for 4 weeks.All the patients before and after 4 weeks of treatment with Hamilton depression scale assessment of depression,applications Ba rthel index assessment activities of daily living,with neurological deficit scores of neurologic impairment evaluation.Results The total effective rate 83% (30/36),the control group was 73% (22/30),the difference was significant (P ＜0.01) ,treatment group after 4 weeks compared with neurological deficit score the control group significantly improved (P ＜ 0.01 ),after 4 weeks treatment group Hamilton Depression Rating Scale ( Ha mi ltiondepressionscale.H AMD) ≥ 17 points were 2 cases of depression was 5% (2/36) the control group 4 weeks after H AMD ≥ 17 points in 6 patients,depression was 20% (6/30),differences were also significant (P ＜ 0.01 ) treatment group,no obvious adverse reactions.Conclusion Early intervention can significantly improve depression in patients with acute stroke depressive symptoms,activities of daily living and to promote recovery of neurological function.