康复科住院患者卒中后抑郁的多因素分析

Multiple factors analysis of depression after stroke in patients hospitalized in rehabilitation department

目的分析康复科住院患者卒中后抑郁的影响因素,为预防和治疗卒中后抑郁提供依据。方法采用17项汉密尔顿抑郁量表(HAMD)、《脑卒中患者临床神经功能缺损程度评分标准》(CNDS)、吞咽障碍临床检查与记录表对109例康复科脑卒中住院患者进行调查。结果康复科患者卒中后抑郁的发病率达84.4%,以轻度(44.95%)、中度抑郁(30.28%)为主。神经功能缺损和吞咽障碍程度为卒中后抑郁的影响因素(P<0.05),且神经功能缺损对抑郁的影响大于吞咽障碍(β=0.274>0.268)。中重度吞咽障碍患者的抑郁得分高于无吞咽障碍患者(P<0.05)。轻度、中度抑郁患者神经功能缺损得分高于无抑郁患者(P<0.05)。各维度比较,中度抑郁患者意识、上肢肌力、下肢肌力得分高于无抑郁患者(P<0.05)。结论临床医务工作者应重视卒中后抑郁,早期对有神经功能缺损或吞咽障碍的患者进行卒中后抑郁的筛查、预防及治疗。

Objective To analyse the influence factors of depression after stroke in hospitalized patients for providing the basis in prevention and treatment of post-stroke depression. Methods The 17 item Hamilton Depression Rating Scale （ HAMD）, the Clinical Neurological Disfunction Scale （CNDS）, the Dysphagia Clinical Examination and Record Table were used to survey 109 cases of rehabilitation hospitalized patients with cerebral apoplexy. Results The incidence of depression after stroke in patients was 84.4%, mainly slight（44.95%） and moderate depression （30.28%）. Neurologic deficits and swallowing d：isorder degree were the influence factors of poststroke depression（P 〈 0.05 ）. Effects of neurological impairment to depression were more than that of dysphagia （β = 0. 274 〉 0. 268 ）. The depression scores of patients with middle or severe dysphagia were higher than in patients without dysphagia（ P 〈 0.05 ）. The neurological disfunction scale of patients with mild or moderate depression were higher than that of patients without depression（ P 〈 0.05）. Conclusion Depression after stroke should be paid more attention to. Early screening, prevention and treatment of poststroke depression should be enhanced in patients with neurological deficits or swallowing disorder.