不同麻醉药物对精神分裂症患者无抽搐电休克治疗的影响

Effects of different narcotics on the efficacy of MECT in schizophrenics

目的:探讨依托咪酯、丙泊酚诱导麻醉后对无抽搐电休克(MECT)治疗精神分裂症患者疗效的影响。方法:将87例需要MECT治疗的精神分裂症患者随机分为两组,丙泊酚组诱导麻醉给予丙泊酚;依托咪酯组诱导麻醉换用依托咪酯,比较两组患者治疗中输入电量指数、运动发作时间、抑制指数、抽搐能量指数、抽搐一致性指数;治疗前、最后一次治疗后以阳性与阴性症状量表(PANSS)和韦氏记忆量表(WMS)评定其精神状况及记忆水平。结果:治疗后依托咪酯组运动发作时间、抑制指数、抽搐能量指数、抽搐一致性指数、WMS评分、PANSS减分均高于丙泊酚组(P均<0.05),而输入电量指数显著低于丙泊酚组(P<0.05)。结论:依托咪酯和丙泊酚比较可提高MECT治疗运动发作时间、抑制指数、抽搐能量指数、抽搐一致性指数,降低输入电量指数,减少认知损害,但须注意谵妄、呕吐和血压问题。

Objective： To explore the effects of anaesthesia induced by etomidate or propofol on the efficacy of MECT in schizophrenics. Methods： Eighty-seven schizophrenics needing MECT were randomly divided into propofol group their induction of anaesthesia by propofol and etomidate group by etomidate. Such indexes as input quantity of electricity, motor attack time, inhibition quotient,tic energy and tic consistency were compared bewteen the 2 groups during treatment; mental status and memory levels were assessed with the Positive and Negative Syndrome Scale（PANSS） and the Wechsler Memory Scale（WMS） before treatment and after the last treatment; data were processed with SPSS12.0. Results： After treatment, such indexes as motor attack time, inhibition,tic energy and tic consistency as well as WMS score and PANSS score-reducing were all higher （all P〈0.05） and input quantity of electricity index was significantly lower （P〈0.05） in the etomidate group than those in the propofol group. Conclusion： Compared with propofol,etomidate can increase motor attack time, inhibition,tic energy and tic consistency, lower input quantity of electricity and reduce cognitive impairment, but attention should be paid to delirium, vomiting and blood pressure.