脑梗死患者抑郁状况及社区综合干预

目的:研究脑梗死患者抑郁状况和社区综合干预的效果。方法:收治发病1年内脑梗死患者220例,随机分为治疗组和对照组,每组各110例,治疗组实施社区综合干预,包括抗抑郁用药指导、健康宣教和心理护理,疗程1年,对照组只进行随访;治疗前后测定患者汉密尔顿抑郁量表(HAMD),以评分>7分为抑郁标准。结果:伴抑郁脑梗死88例(40%),治疗前治疗组伴抑郁45例(40.9%),对照组43例(39.1%);治疗后分别为19例(17.3%)和31例(28.2%),X2=6.87,P<0.05差异有显著性。治疗前治疗组和对照组伴抑郁患者HAMD评分分别为18.3±5.3和17.9±5.8;治疗后分别为11.9±3.4和16.3±5.1,t=7.53,P<0.01差异有显著性。治疗组新发脑梗死8例,死亡1例;对照组分别为12例和2例。结论:社区综合干预可以明显改善脑梗死患者抑郁状况,从而改善患者长期预后,减少脑梗死复发。

Objective:To study the depression status and the influence of community based comprehend intervention on prognosis in patients with cerebral infarction.Methods:220 cases with cerebral infarction onset within one year were randomly divided into treatment and control groups,110 cases for each group.The cases in therapy groups carried out community-based comprehend intervention including the anti-depression medicine guide and health education and psychological care,treatment courses was one year,control group only for follow-up.All patients were detected HAMD scale before and after treatment.The depression criteria is HAMD score more than 7 points.Re-sults:There were eighty-eight(40%) cases with depression in all patients with cerebral infarction.Before treatment,there were forty-five(40.9%) cases with depression in therapy groups and forty-three(39.1%) in control groups;After treatment,there were nineteen(17.3%) cases and thirty-one(28.2%) in two groups;there is a significant difference(X2 = 6.87,P < 0.05).Before treatment,HAMD score of patients accompanied depression was 18.3 ± 5.3 in therapy groups and 17.9 ± 5.8 in control groups;After treatment HAMD score was 11.9 ± 3.4 and 16.3 ± 5.1 in two groups,there is a significant difference(t = 7.53,P < 0.01).There were eight recurrence cases and one dead cases in therapy group,vs twelve and two cases in control group.Conclusion:By community-based comprehend intervention,the depression status of patients with cerebral infarction are significantly improved and the quality of life is higher after one year,and it is worthy of reduce the recurrence of cerebral infarction.