心理康复对脑卒中恢复早期患者预后的影响

Effects of Psychological Rehabilitation on Prognosis of Patients in Early Recovery Stage of Cerebral Stroke

目的探讨心理康复对脑卒中恢复早期患者预后的影响。方法根据汉密尔顿抑郁量表评分(HAMD)标准将124例脑卒中恢复早期患者分为抑郁组和无抑郁组,抑郁组又随机分为两组:抑郁治疗组和抑郁对照组。抑郁治疗组采用常规治疗的同时进行系统的心理康复;无抑郁组和抑郁对照组采用常规治疗。连续观察8周,观察其肢体运动功能(Fugl-Meyer运动功能评定:FMA)、ADL能力(改良巴氏指数:MBI)及HAMD的变化情况。结果抑郁治疗组治疗2,4,8周后FMA、MBI及HAMD评分分别与抑郁对照组比较均有显著性差异(P<0.05或P<0.001);抑郁治疗组治疗8周后FMA、MBI及HAMD评分与无抑郁组比较均无显著性差异(P>0.05)。结论心理康复可以促进脑卒中恢复早期伴抑郁障碍患者全面康复。

Objective To study the effects of psychological rehabilitation on the prognosis of stroke patients. Methods Hamilton Depression （HAMD） scale was apphed to the evaluation of 124 cerebral stroke patients soon after they were discharged. Fifty-six ot them （45.2%） who were diagnosed as depression were randomized into trial group receiving psychological rehabilitation besides routine treatments for 8 weeks （ n = 28 ） and control group （ n = 28 ） receiving routine treatments alone. By the ends of 2, 4 and 8 weeks after treatment, the scores of Fugl-Meyer Assessment （FMA） , Modified Barthel Index （MBI） and HAMD were compared. Results By the ends of 2, 4 and 8 weeks after treatment, the patients in the trial group got much better scores in FMA and MBI than those in the control group, and the score of HAMD in the trial group was lower than that in the control group. The differences were statistically significant （P 〈0.01, or P 〈0. 001 ）. The final scores of FMA, MBI and HAMD in the trial group were close to that in the non - depression group （ P 〉 0.05 ）. Conclusion Psychological rehabilitation promotes the rehabilitation of the patients with depression in early recovery stage of cerebral stroke.