无抽搐电休克治疗精神分裂症前后认知功能的变化

Changes of cognitive function in patients with refractory schizophrenia before and after modified electric shock therapy

目的探讨精神分裂症无抽搐电休克治疗前后认知功能的变化。方法选取收治的急性发作的精神分裂症患者,其中无抽搐电休克(MECT)组(MECT组)、药物治疗无MECT组(对照组)治疗适应症的患者各30例,两组均根据患者病情给予个体化抗精神病药物治疗,MECT组同时给予MECT治疗,共治疗6周12次为一个疗程。以威斯康星卡片分类测验(WCST)观察患者治疗前、治疗6周时认知功能。结果 WCST测验中正确应答数、错误应答数两组治疗前比较差异无统计学意义(P>0.05),治疗后错误应答数较治疗前下降(P<0.01),MECT组较对照组下降更为明显(P<0.01);MECT组治疗总有效率(治愈率+显效率)为83.33%高于对照组56.66%(P<0.05)。结论精神分裂症无MECT治疗有助于改善认知功能,相对于未使用MECT治疗者认知功能改善明显。

Objective： To investigate the changes of cognitive function before and after treatment in patients with refrac- tory schizophrenia. Methods ： Thirty cases of the patients with acute episodes of intractable mental disorder of schizophrenia in our hospital were treated by no convulsions electro convulsive therapy （ MECT group） and no MECT （ control group）. Two groups were given individual antipsychotic treatment according to the condition of patients and MECT group also given electroconvulsive therapy, and treated 12 times for 6 weeks in a course of treatment. The Wisconsin Card Sorting Test （WCST） was used to observe cognitive functions in 6 weeks before treatment and treatment. Results： The correct responses and the error responses of two groups of treatment showed no statistical significance in the WCST （ P 〉 0.05 ）, the number of incorrect response decreased after treatment compared with those before treatment（ P 〈 0.01 ） and compared with the con- trol group, the MECT group decreased more obviously（ P 〈 0.01 ） ; in the MECT treatment group the total effective rate （ cure rate ＋ significant efficiency） was 83.33% higher than that of the control group 56.66% （P 〈 0.05 ）. Conclusion： The treatment of refractory schizophrenia without MECT is helpful to improve the cognitive function, and the cognitive func- tion of the patients without MECT treatment is significantly improved.