甲状腺手术前患者米氮平抗焦虑抑郁治疗的研究

Efficacy of Mirtazapine in treatment of depression and anxiety in patients with thyroid surgery

目的评估米氮平治疗甲状腺疾病患者手术前焦虑及抑郁情绪的效果。方法对2009年1月—2010年6月住院的60例甲状腺疾病患者在入院后手术前进行汉密尔顿抑郁量表(HAMD)和汉密尔顿焦虑量表(HA-MA)的评估,将HAMA评分≥14及HAMD评分≥17的患者作为焦虑抑郁患者随机分为实验组(30例)和对照组(30例)。实验组采用手术+米氮平治疗,对照组仅采用手术治疗。观察4周,比较两组术后精神情绪变化。结果与术前基线检查相比,术后一周研究组HAMD评分大于对照组[(5.2±1.7)、(2.9±1.4),F=0.79,P<0.05),差异有统计学意义。术后4周研究组HAMD和HAMA评分均大于对照组(HAMD:12.6±1.3、5.7±1.8,F=1.8,P<0.05;HAMA:(9.9±2.2)、(4.6±1.4),F=5.2,P<0.05],差异均有统计学意义。术后4周,实验组患者焦虑缓解率(86.7%,26/30)高于对照组(40.0%,12/30),差异有统计学意义(P<0.05),抑郁情绪缓解率(83.3%,25/30)也高于对照组(36.7%,11/30)(P<0.05)。结论手术前给予患者米氮平抗抑郁焦虑治疗较单纯手术治疗疗效更好。

Objective To assess the effect of anxiety and depression antidepressant treatment for patients before thyroid surgery.Methods All the patients with thyroid disease were admitted from January 2009 to June 2010,60 cases of patients with thyroid disease were hospitalized.The Hamilton Depression Rating Scale（HAMD） and Hamilton Anxiety Scale（HAMA） assessment before surgery,the data of HAMA and HAMD（≥ 17 and ≥14） indicated anxiety and depression.The patients were randomly divided into study group（30 cases） and control group（30 cases）.Study group with surgery plus mirtazapine treatment,the control group using conventional surgery.Observed 4 weeks after surgery and compared mood changes. Results Compared with the baseline examination,a week after surgery the HAMD reduction difference between study group and control group was statistically significant（P0.05）.After 4 weeks HAMD and HAMA of study group were higher than those the control group（P0.05）.Remission rate of anxiety patients of the study group（86.7%,26/30） higher than that of control group（40.0%,12/30） after 4 weeks,the difference was statistically significant（P0.05）,depression remission rate（83.3%,25/30） is also higher（36.7%,11/30）（P0.05）. Conclusions The patients with thyroid surgery had depression and anxiety emotion before surgery.Surgery combined with mirtazapine therapy is better than a simple surgical treatment.