早期联合抗抑郁治疗对脑卒中后手功能障碍并发抑郁的影响

Combination of Early Rehabilitation and Anti-depression Therapy in Stroke Patients with Hand Dysfunction and Depression

目的:探讨脑卒中后手功能障碍并发抑郁患者早期综合康复治疗的临床疗效。方法:脑卒中后手功能障碍并发抑郁患者56例,随机分为A、B 2组各28例,均按神经内科脑血管病常规处理,并配合综合康复治疗。A组在治疗过程中针对患者心理状况给予心理疏导及增加抗抑郁药物治疗。结果:治疗3周后2组患者的汉密尔顿抑郁量表(HAMD-24)评分与治疗前比较均有下降,A组更显著;Lindmark手运动功能评分、Barthel指数评分与治疗前比较2组均有明显提高,2组间比较A组明显高于B组(均P<0.05)。结论:早期康复联合抗抑郁治疗能明显缓解脑卒中后手功能障碍患者的抑郁症状,治疗的依从性和肢体功能明显提高,提示脑卒中手功能障碍并发抑郁患者配合心理干预有重要意义。

Objective： To study the clinical effects of early comprehensive rehabilitation combined with anti-depression treatment in stroke patients with hand dysfunction and depression. Methods： Fifty-six stroke patients were randomly divided into two groups （n=28 each）. The patients in observation group （A） received comprehensive therapy including psychotherapy, conventional rehabilitation and antidepressant drug, and those in control group （B） were treated by conventional rehabilitation therapy. The subjects were assessed by the changes of depression emotion and the ability of daily living with HAMD, Barthel index and Lindmark hand function. Results： There were differences between two groups after treatment. Patients in group A showed lower HAMD, higher Barthel index and Lindmark hand function than in group B 3 months after treatment. Conclusion： Early comprehensive rehabilitation combined with antiepression treatment can improve depression emotion and common living ability of the stroke patients with hand dysfunction and depression.