现代电休克治疗在老年难治性精神分裂症中的应用

The utilization of MECT for the geriatric resistant schizophrenics

目的:评价联合急性期MECT及维持期MECT对老年难治性精神分裂症的疗效及安全性。方法:对20例老年难治性精神分裂症(最近一次使用氯氮平治疗无效),联合急性期MECT及维持期MECT,分别在MECT治疗前、急性期治疗结束、维持治疗3个月末、维持治疗6个月末,测评PANSS量表以评定疗效。用TESS量表评定不良反应。结果:(1)急性期MECT结束时与治疗前比较,PANSS总分、阳性症状、一般精神病理评分有明显下降;阴性症状评分有下降。(2)所有入组患者在急性期MECT结束时均有效。维持期MECT 6个月末、3个月末与治疗前比较,PANSS总分、阳性症状、阴性症状、一般精神病理评分均有明显下降。(3)急性期MECT有轻度不良反应。结论:联合MECT治疗对氯氮平无效的老年难治性精神分裂症患者,不仅在急性治疗期有效,而且在维持期也可能提供了一个较好方法。

Objective：To explore the effect and tolerance of combining acute and maintenance MECT for the geriatric resistant schizophrenics. Methods：20 geriatric resistant schizophrenics with clozapine -resistent recently were treated with combining acute and maintenance MECT. The PANSS was used to rate the patients before the MECT, at the end of acute MECT, at the end of third and sixth month in maintenance MECT. The effects were evaluated by the PANSS and the tolerance by TESS. Results： （ 1 ） Comparing the end with the before of acute MECT, the total scores of PANSS, the scores of Positive Symptom and General Psychopathology reduced significantly and the scores of Negative Symptom reduced. （2） 20 patients were all effective at the end of acute MECT. Comparing the end of third and sixth month in maintenance MECT with the before of acute MECT, the total scores of PANSS, the scores of Positive Symptom, Negative Symptom and General Psychopathology all reduced significantly. （3） Acute MECT has mild side effect. Conclusions： Combining MECT may be effective for the geriatric resistant schizophrenics with clozapine - resistent recently not only in acute but also in maintenance therapy.