无抽搐电休克治疗精神分裂症伴激越行为疗效观察及护理干预

Efficacy of MECT for schizophrenia with agitation behaviors and nursing inter- vention

目的探讨无抽搐电休克治疗精神分裂症伴激越行为的临床效果及护理方法。方法将60例伴激越行为的精神分裂症患者随机分为两组，每组30例。对照组给予肌内注射氟哌啶醇治疗，研究组予以无抽搐电休克治疗。观察14d。于治疗前及治疗1d、7d、14d末采用阳性与阴性症状量表、临床总体印象量表疾病严重程度分量表、副反应量表评定临床疗效及不良反应。结果治疗1d末研究组阳性与阴性症状量表总分较治疗前显著下降（P〈0．05）；治疗7d末两组阳性与阴性症状量表总分及阳性症状、兴奋症状因子分和研究组临床总体印象量表疾病严重程度分量表评分均较治疗前显著下降（P〈0．01），但研究组兴奋症状因子分和临床总体印象量表疾病严重程度分量表评分显著低于对照组（P〈0．05或0．01）；治疗14d末两组阳性与阴性症状量表总分及阳性症状、兴奋症状因子分和临床总体印象量表疾病严重程度分量表评分均较治疗前显著降低（P〈0．01），且研究组显著低于对照组（P〈0．05或0．01）。治疗7d末起，研究组副反应量表评分较治疗1d末显著下降（P〈0．01），且显著低于对照组（P〈0．05）。治疗后研究组不良反应主要为短暂记忆障碍（30．0％）、头痛（26．7％）、肌强直（23．3％）。结论无抽搐电休克治疗精神分裂症伴激越行为疗效显著，起效快，安全性高。

Objective To explore the efficacy of modified electroconvulsive therapy （MECT） for schizo- phrenia with agitation behaviors and nursing methods. Methods Sixty schizophrenics with agitation be- haviors were randomly assigned to two groups of 30 patients each, control group received haloperidol IM and research group did MECT for 14 days. Efficacies were assessed with the Positive and Negative Syn- drome Scale （PANSS） and Clinical Global Impression-severity of illness （ CGI SI） and adverse reactions with the Treatment Emergent Symptom Scale （TESS） before treatment and at the end of the 1st, 7th and 4th day. Results At the end of the 1st day the PANSS total score lowered more significantly compared with pretreatment in research group （P〈0.01） ; at the end of the Th day, total and positive and excited symptoms scores of both groups as well as CGI-SI score in research lowered more significantly compared with pretreatment （P〈0.01）, but excited symptoms scores of the PANSS and CGI-SI score were signifi- cantly lower in research than in control group （P〈0.05 or 0.01） ; at the end of the 14th day, total and pos- itive and excited symptoms scores of the PANSS as well as CGI-SI score of both groups lowered more sig- nificantly compared with pretreatment （P〈0.01）, so did those in research than in control group （P〈0.05 or 0.01）. Since the end of the 7th day the TESS score lowered more significantly in research compared with the end of the 1st day （P〈0.01） and than in control group （P〈0.05）. After treatment adverse reactions in research group were mainly transient dysmnesia （30.0%）, headache （26.3%） and myotonia （23.3%）. Conclusion MECT has an evident effect and higher safety, takes effect rapidly in schizophrenia with agita- tion behaviors.