MECT治疗精神障碍的不良反应及相关因素分析

Adverse event and related factors analysis of modified electro-convulsive therapy in the treatment of mental disorder

目的：探讨无抽搐电休克治疗（modified electroconvulsive therapy,MECT）术后不良反应及其相关因素。方法 ：对2014年到2015年期间,在上海市嘉定区精神卫生中心住院期间接受MECT治疗的964例精神障碍患者进行MECT术后不良事件的记录和比较。结果 ：共报告不良事件119例（12.34%）;女性报告不良事件的发生率显著高于男性（χ~2=13.964,P=0.000）。不同精神疾病的不良事件报告率存在显著差异（χ~2=9.736,P=0.004）,其中情感性障碍的不良事件报告率最高。丙泊酚麻醉后导致近记忆减退的发生率显著高于依托咪酯（χ~2=8.111,P=0.005）;而依托咪酯麻醉后导致急性谵妄的发生率显著高于丙泊酚（χ~2=9.201,P=0.003）。结论 ：MECT在治疗上总体安全,但也应注意其不良反应并及时处理,特别是发生意识不清（急性谵妄）时,应密切观察。

Objective： To explore the adverse event and related factors of modified electroconvulsive therapy（MECT） on patients with mental disorder. Methods： The data of post-operative adverse events in the patients who received MECT during hospitalization from 2014 to 2015 in Jiading Mental Health Center,Shanghai were retrospectively analyzed. Results： The adverse events were seen in 119 cases of patients（12.34%） and the incidence of adverse events was significant higher in female than male（χ~2=13.964,P=0.000）. There existed some obvious differences in the reported incidence of adverse events in different kinds of mental disorders（χ~2=9.736,P=0.004）,in which the highest occurred in the patients with affective disorder. The incidence of recency memory decline caused by propofol anesthesia was obviously higher than that by etomidate（χ~2=8.111,P=0.005）while the incidence of acute delirium caused by etomidate was higher than that by propofol（χ~2=9.201,P=0.003）. Conclusion： MECT is a safe and effective treatment method in clinic,but the adverse reaction should be carefully monitored and intervened in time,especially when the acute delirium occurs.