因时康复护理与心理疏导治疗脑卒中偏瘫患者致抑郁症随机平行对照研究

目的 探讨心理疏导联合康复护理治疗脑卒中抑郁症的临床疗效。 方法 筛选2014年3月-2016年3月哈尔滨医科大学附属第一医院收治的104例缺血性脑卒中偏瘫后致抑郁症患者,按随机数字表法将所有患者随机分为对照组(52例)和治疗组(52例)。所有患者根据《中国脑卒中康复治疗指南》予常规措施,予降糖调脂、调整血压、纠水电解质紊乱及神经营养药物治疗等,必要者行吸氧、预防感染等措施,同时口服阿司匹林肠溶片等。对照组采取氟哌噻吨美利曲辛治疗,每日早晨口服1片。治疗组在对照组基础上予因时康复护理(入院当天、入院第2天开始、出院后)与依据患者个体差异进行心理疏导治疗。2组均给予6周疗程观察。比较2组抑郁自评量表(SDS)、HAMD量表因子及神经功能缺损程度评分量表(CSS)评分。分析2组临床疗效。 结果 治疗后3周和6周,治疗组患者的SDS评分显著少于同期对照组(均P<0.01)。治疗后,治疗组患者的HAMD量表因子评分显著低于对照组(P<0.01)。治疗组的总有效率为92.31%,显著高于对照组76.92%(P<0.05)。治疗后6周和12周,治疗组CSS评分显著少于对照组(P<0.01)。 结论 因时康复护理与心理疏导治疗脑卒中偏瘫致抑郁症可改善患者抑郁症状,促进神经功能恢复。 

Efficacy of the rehabilitation nursing with the seasons' change of time combined with psychological counseling in treating patients with depression of stroke hemiplegia

Objective To investigate the efficacy of the rehabilitation nursing with the seasons' change of time combined with psychological counseling in treating patients with depression of stroke hemiplegia. Methods One hundred-four patients with post-stroke depression were chosen and randomly divided into control group and treatment group. All cases were given routine treatment referring to "Chinese stroke rehabilitation treatment guidelines". We regulated their blood sugar and blood fat level and blood pressure, corrected water electrolyte disorder, treated them with neurotrophic drugs, used oxygen uptake and infection prevention if necessary, and took orally aspirin enteric-coated metformin hydrochloride. Control group received Flupentixol and Melitracen every day with 1 tablet in morning. Based on the control group, treatment group was treated with the rehabilitation nursing with the seasons' change of time (on the day of admission, 2 days in hospital, and post-discharge) combined with psychological counseling according to the patient's individual differences. Efficacy was evaluated after 6 weeks. Scores of SDS, HAMD scale, and CSS were compared between two groups. Efficacy was analyzed in both groups. Results SDS score of treatment group was evidently lower than control group after 3 and 6 weeks' treatment (P<0.01). After treatment, scores of HAMD scale factors of treatment group were lower than those in control group (P<0.01). Total efficacy rate of treatment group was 92.31%, which was higher than control group as 76.92% (P<0.05). CSS score of treatment group was obviously lower than control group after 6 and 12 weeks' treatment (P<0.01). Conclusion Rehabilitation nursing with the seasons' change of time combined with psychological counseling in treating patients with depression of stroke hemiplegia can improve depression, and promote recovery of neural function.