早期综合干预对脑梗死后抑郁及神经功能恢复的影响

Effect of Early Comprehensive Intervention on Poststroke Depression and Rehabilitation of Neurological Function

【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恢复的影响。【方法】采用多种量表评分对120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】观察组与对照组各60例全部完成随访。HAMD-17在干预后4周、8周和6个月观察组明显优于对照组(P<0.001)。SSS评分在干预后4周、8周和6个月观察组明显优于对照组(P<0.01)。抑郁症状观察组治愈43例(71.66%)、有效60例(100%),对照组治愈4例(6.66%)、有效9例(15%),两组相比差异显著(P<0.01)。【结论】早期综合干预对脑梗死后抑郁具有很好的疗效,在一定程度上可加快卒中后神经功能的恢复。

[Objective]To investigate therapeutic effects of early comprehensive intervention（ psychotherapy plus antidepressant）in treatment of depression after ischemic stroke and its effect on functional outcome. [Methods]A controlled prospective design was applied in this study of 120 patients with depression after ischemic stroke . Several scales were used for functional measure. [Results]All cases were observed. 60 patients （observed group）received comprehensive therapy and routine treatment of isehemic stroke, 60 patients（control） received routine treatment only. At the 4th week after treatment and 8 weeks,6 months after stroke, observed group was significantly more effective than control group by reduction in 17-item Hamilton Depression Rating Scales（HAMD-17） and Edinburgh-Scandinavian Scoring Seale（SSS）. In observed group, the effective rate of antidepressant therapy was 100% and the cure rate was 71.66% , these results were significantly better than the counter parts of control group （15 % and 6.66% respectively. P 〈0. 001 ）. [Conclusion]Early comprehensive intervention has good efficacy in post-ischemic stroke depression.