抑郁症患者无抽搐电休克治疗使用不同麻醉药物时眼压及抑郁减分的对比研究

A comparative study of intraocular pressure and depression reducing score in depression patients undergoing MECT with different anesthetics

目的研究抑郁症患者无抽搐电休克治疗（MECT）分别使用氯胺酮、丙泊酚麻醉时对眼压及抑郁减分的影响。方法将符合MECT治疗条件的患者随机分为氯胺酮组（n=27）和丙泊酚组（n=29），测量记录麻醉前（TO）、治疗后1h（T1）、治疗后24h（T2）的眼压。使用汉密尔顿抑郁量表17项为患者在T0、T2时点评分。结果氯胺酮组治疗后T1时点眼压高于丙泊酚组（P〈0．05），T0、T2时点比较差异未见统计学意义（P〉0．05）；氯胺酮组他时点症状减分高于丙泊酚组（P〈0．05），T0时点比较差异未见统计学意义（P〉0．05）。结论抑郁症患者MECT使用氯胺酮麻醉时抑郁减分显著，但要考虑眼压升高的危险性。

Objective To study the effects of ketamine and propofol on intraocular pressure and depression reducing score of depression patients undergoing modified electroconvulsive therapy（MECT）. Methods Patients conformed to the MECT treatment conditions were randomly divided into the ketamine group （ n = 27 ） and propofol group （ n = 29 ）, intraocular pressures were measured and recorded before anesthesia（T0） and in the 1 hour（ T1 ） and 24 hours（T2） after treatment. TO and T2 assessments were conducted with the 17-item Hamilton Depression Rating Scale （ HAMD-17 ）. Results The intraocular pressure at T1 time point in ketamine group was higher than that in propofol group （P 〈 0. 05 ）, but the differences were not significant at TO and T2 time point （P 〉 0. 05）. The symptom reducing score at T1 time point in ketamine group was higher than that in propofol group （P 〈 0. 05 ）, but the differences were not significant at TO and T2 time point （P 〉 0. 05）. Conclusions Depression reducing score of depression patient undergoing MECT with ketamine anesthesia is significant, but the risk of elevated intraocular pressure should be considered.