脑卒中后抑郁综合护理干预60例

Comprehensive Nursing Intervention for Poststroke Depression for 60 Cases

目的探讨综合护理干预措施对脑卒中后抑郁(PSD)患者预后的影响。方法将60例脑卒中后抑郁患者随机分为心理护理组和空白组各30例。空白组给予常规治疗、护理及康复训练,心理护理组在早期康复治疗基础上采取心理护理。护理前后分别进行汉密尔顿抑郁量表、神经缺损功能评分评定。两组的治疗方案相同,对照组采用常规护理,观察组在常规护理基础上给予心理护理和认知行为护理等综合护理干预。结果 60例抑郁患者治疗后严重抑郁7例、中度抑郁3例、轻度抑郁50例;显效13例,有效11例,总有效率为80.00%。两组护理干预前的HAMD评分和MMSE评分比较差异无统计学意义(P均>0.05),护理干预后观察组的HAMD和NIHSS评分较干预前和空白组显著降低(P<0.05)。结论对PSD患者采用综合护理干预措施可有效改善患者的抑郁情绪和认知功能障碍,有助于促进神经功能康复,提高生活质量,值得临床推广应用。

Objective To discuss the effect of comprehensive nursing intervention for poststroke depression（PSD）.Methods 60 patients with PSD were randomly divided into psychological nursing group and blank group, and each group had 30 cases. The blank group was given conventional treatment, nursing and rehabilitation training. The psychological nursing group received psychological nursing based on the early rehabilitation treatment. Before and after nursing, the Hamilton depression rating scale and deficiency of neural function were evaluated. The two groups used the same treatment plan. The control group used conventional care, and the observation group was given psychological nursing and comprehensive nursing interventions such as cognitive behavioral nursing on the basis of routine nursing care.Results After treatment, in the 60 patients, 7 cases were severe depression, 3 patients were moderate depression, 50 cases were mild depression; 13 cases had markedly effect, 11 cases had effect, and the total effective rate was 80.00%. Before nursing intervention, there was no statistically significant difference in HAMD scores and MMSE score of the two groups（all P〉0. 05）, and the difference had no statistical significance. After nursing intervention, the HAMD and NIHSS score of the observation group significantly reduced comparing with the blank group and before treatment（ P〈0.05）. Conclusion The comprehensive nursing intervention for PSD patients can effectively improve the depression and cognitive dysfunction, help to promote neural function rehabilitation, and improve the quality of life.It is worthy of clinical popularization and application.