心理治疗对颅脑损伤术后瘫痪患者心理健康及肢体运动功能障碍的影响

Effect of Psychological Treatment on Mental Health and Limb Dyskinesia in Patients with Paralysis after Operation for Craniocerebral Injury

目的：探索心理治疗对颅脑损伤术后瘫痪患者心理健康及肢体运动功能障碍的影响。方法：选取我院90例颅脑损伤术后瘫痪患者,随机选取45例患者作对照组给与常规康复治疗干预,再随机取45例患者作研究组,增加心理治疗干预。分别于干预前、干预6个月后对比两组患者心理健康、生活质量、上下肢肌力、上下肢运动功能状况。结果：干预6个月后,研究组患者躯体化（t=2.25,P〈0.05）、强迫症（t=2.03,P〈0.05）、人际关系（t=2.08,P〈0.05）、抑郁（t=2.70,P〈0.05）、焦虑（t=2.04,P〈0.05）、敌对（t=2.25,P〈0.05）、恐怖（t=2.01,P〈0.05）、偏执（t=2.49,P〈0.05）、精神病性（t=2.08,P〈0.05）评分均显著低于对照组;研究组患者活动能力（t=7.03,P〈0.05）、日常生活（t=2.37,P〈0.05）、健康感觉（t=2.73,P〈0.05）、家庭及朋友支持（t=9.12,P〈0.05）、生活前景认识（t=3.27,P〈0.05）评分均显著高于对照组;研究组上肢肌力（χ^2=4.12,P〈0.05）、下肢肌力（χ^2=3.88,P〈0.05）改善显著优于对照组;研究组上肢运动能力（t=13.85,P〈0.05）、下肢运动能力（t=17.51,P〈0.05）显著高于对照组。结论：心理治疗能显著改善颅脑损伤术后瘫痪患者心理健康状态、提高患者生活质量、改善患者肢体肌力、提高患者肢体运动功能,值得临床在常规康复治疗中加以运用。

Objective：To explore the effect of psychological treatment on the mental health and limb dyskinesia in patients with paralysis after operation for craniocerebral injury.Methods：A total of 90 patients with paralysis after operation for craniocerebral injury in the hospital were selected.45 patients given conventional rehabilitation intervention were included into the control group while 45 patients additionally given psychological intervention were included into the study group.The mental health,quality of life,muscle strength and motor function of upper and lower limbs were compared between the two groups before the intervention and after 6 months of intervention.Results：After 6 months of intervention,scores of somatization,obsessive-compulsive disorder,interpersonal relationships,depression,anxiety,hostility,terror,paranoia and psychoticism in the study group were significantly lower than those in the control group（t=2.25,2.03,2.08,2.70,2.04,2.25,2.01,2.49,2.08;P〈0.05）while scores of mobility,activities of daily living,healthy feeling,family and friend support and awareness of outlook on life were significantly higher than those in the control group（t=7.03,2.37,2.73,9.12,3.27;P〈0.05）.The improvement of muscle strength of upper limb（χ^2=4.12,P〈0.05）and lower limbs（χ^2=3.88,P〈0.05）in stud group were significantly better than those in the control group.The motor function of upper limb（t=13.85,P〈0.05）and lower limb（t=17.51,P〈0.05）in study group were significantly better than those in the control group.Conclusion：Psychological treatment can significantly improve the mental health status,quality of life,limb muscle strength and limb motor function in patients with paralysis after operation for craniocerebral injury.