脑中风患者心理应激、干预与康复

目的:探讨生活事件、心理应激与脑中风发生、发展的关系;心理治疗干预在脑中风康复中的作用。方法:110例急性脑中风患者分为干预组52例,采用药物 心理治疗干预(音乐电疗、心理疏导、放松训练);非干预组58例,予以单纯药物治疗。正常对照组80例。治疗前对所有被试者行生活事件量表(LES)Derogatis90项症状自评量表(SCL-90)测试,脑卒中患者行神经功能缺损量表判定。治疗后只测SCL-90及神经功能缺损分值,并行治疗前后及组间比较。结果:脑中风患者治疗前LES、SCL-90评分明显高于对照组(P<0.01),治疗后干预组SCL-90各因子分明显低于非干预组(P<0.05);治疗后神经缺损评分较治疗前降低,以干预组明显(P<0.01),与非干预组比较差异显著(P<0.05)。心理障碍程度与神经功能缺损程度呈正相关(r=0.238)。结论:生活事件、心理因素是脑中风的主要诱发因素,其并发症、继发症的发生、发展与心理应激相关;及时、正确地治疗处理中风患者的情绪障碍是中风康复的重要环节。

A study of relationship among psychological stress,psychotherapy and stroke

Objective:To explore the relationship among life event,psychological stress and the genesis,compication,secondary disease of stroke,and to determine effect of psychotherapy in the rehabilitation of stroke.Method:All110patients of acute stroke were randomly divided into intervention group(group1,n=52)and no intervention group(group2,n=58).Group1was trearted with pharmacotherapy and psychotherapy(musicotherapy,electrotherapy,relaxation),while group2was treated with pharmacotherapy only.Before the treatment,their mental status was evaluated by Life Event Scale(LES)and Derogatis' s Symptom Checklist-90(SCL-90),and the degree of their neurological defection was judged by Stroke Neurological Defect Scale(SNDS).After treatment the two groups were tested by SCL-90and SNDS,and made self-contrast,groups-contrast and comparsion with80healthy controls.Result:The grade of LES and SCL-90in stroke patients was significantly higher than that in normal controls(P<0.01).The grade of SCL-90in group1was significantly lower than that in group2after treatment(P<0.05).The grade of SNDS was lower after treatment(P<0.05),especially in group1.The cure rate in group1was significantly higher than that in group2.The degree of mental disorder was positively related to the degree of defect in neural function(r=0.238).Conculsion:Life event and psychological stress are major evoking factors of stroke.The genesis and development of complication and secondary disease of stroke are directly correlated with psychological stress.The rational treatment on mental disorder is important in the rehabilitation of stroke.