脑梗死后抑郁早期综合干预的随访观察

目的探讨早期综合干预对脑梗死后抑郁症状的疗效及对神经功能康复的影响。方法采用多种量表评分对96例脑梗死后抑郁患者进行随机对照并随访6个月的前瞻性研究。结果研究组50例与对照组46例均完成随访。汉密尔顿抑郁量表17项分在干预后4周、卒中后3、6个月,研究组均明显优于对照组(P<0.01)。抑郁症状在研究组治愈22例(44.09%),有效23例,有效率90.01%;对照组治愈2例(4.3%),有效7例,有效率19.5%,治疗组有效率高于对照组(2χ=48.298,P=0.000)。巴氏指数在干预后各时点研究组均优于对照组(P<0.015))。神经功能缺损量表分在干预后4周研究组(7.024±5.41)优于对照组(10.664±8.53,P=0.05),卒中后3、6个月两组无显著差异。结论早期综合干预对脑梗死后抑郁有很好的疗效,可以加快脑梗死后神经功能的康复,提高患者的日常活动能力。

Early comprehensive intervention on depression after cerebral infarction

Objective To investigate the therapeutic effects of early comprehensive intervention(psychotherapy plus antidepression) on the depression and neurofunctional recovery after cerebral infarction.Methods A controlled prospective design was applied in this study of 96 patients with depression after cerebral infarction.Several scales were used for functional assessment.All cases were followed up.Fifty patients(study group) received comprehensive therapy after stroke,and 46 patients(control group) received routine therapy.Results At the 4th week after treatment and 3 or 6 months after cerebral infarction,study group showed more effective than control group according to the Hamilton Depression Rating Scale(HMAD-17) and Bardthel Index(BD).The study group had significant differences than control group in Neurological Functional Deficit Scores(NFDS) at the 4th week after therapy,but there was no difference at 3 or 6 months after stroke.In study group,the effective rate of antidepression therapy was 90.0% and the cure rate was 44.0%.These results were significantly better than control group(19.5% and 4.3%,P<0.01).Conclusion Early comprehensive intervention has good efficacy on depression after cerebral infarction.It can accelerate neurofunctional recovery and ameliorate the ability of daily activities