心理干预对脑卒中后抑郁治疗效果的观察

Effects of psychological intervention in treatment of post-stroke depression

目的观察心理干预对脑卒中后抑郁的治疗效果。方法从2013年4月到2014年1月,选取我院的96例脑卒中后抑郁患者进行回顾性分析。将其分为两组:对照组44例患者,采用早期康复和脑卒中常规药物治疗;观察组52例患者,在对照组基础上采用心理干预治疗。结果治疗前两组HAMD评分差异无统计学意义(P>0.05)。治疗8周后,两组的HAMD评分较治疗前均有降低,差异均有统计学意义(P<0.05)。但观察组降低更明显,治疗后HAMD评分两组间比较,差异有统计学意义(P<0.05)。观察组痊愈占比61.54%(32/52),有效率为98.08(51/52),均显著高于对照组的38.64%(17/44)和79.55%(35/44),差异均有统计学意义(P<0.05)。两组患者完全依从和总依从在治疗前差异无统计学意义(P>0.05),治疗8周后,两组患者完全依从和总依均较治疗前提高,差异有统计学意义(P<0.05),观察组较对照组提高更显著,差异有统计学意义(P<0.05)。结论对脑卒中后抑郁患者,在早期康复和常规药物治疗的同时采用心理干预治疗,不但可以改善抑郁症状,而且可以提高患者康复依从性,促进脑卒中后神经功能的恢复,值得临床进一步推广。

Objective To observe the therapeutic effects of psychological intervention in the treatment of depression in patients after stroke. Methods Ninety-six patients with post-stroke depression treated in our hospital from April 2013 to January 2014 were selected and analyzed retrospectively. These patients were divided into two groups： control group with 44 patients,with application of early rehabilitation and conventional drug treatment for stroke; observation group with 52 patients,with addition of psychological intervention to the regimen applied in the control group. Results The scores of Hamilton Depression Scale（ HAMD） before treatment were similar between the two groups with no significant difference（ P〉0. 05）. After the treatment for 8 weeks,HAMD scores decreased significantly in both groups compared with the values before treatment（ P〈0. 05）,but the decrease in the observation group was greater. The difference in HAMD score after treatment between the two groups had statistical significance（ P〈0. 05）. In the observation group,the cases with recovery accounted for 61. 54%（ 32 /52）,and the response rate was 98. 08%（ 51 /52）,significantly higher than the corresponding rates in the control group [38. 64%（ 17 /44） and 79. 55%（ 35 /44）,respectively]（ P〈0. 05）. Before treatment,full compliance and total compliance showed no significant differences between the patients in the two groups（ P〉0. 05）; after the treatment for 8 weeks,full compliance and total compliance were significantly improved（ P〈0. 05）,but the observation group had a significantly more improvement than the control group（ P〈0. 05）. Conclusions In patients with post-stroke depression,application of psychological intervention during early rehabilitation and conventional drug treatment can relieve the symptoms of depression,improve the patient＇s compliance with rehabilitation,and promote the recovery of neural function after stroke; therefore,this regimen is worthy of clinical promotion.