探究MECT治疗老年难治性精神分裂症的效果

Analyze the Effect of MECT in the Treatment of Refractory Schizophrenia in the Elderly

目的探讨无抽搐电休克(MECT)治疗老年难治性精神分裂症的疗效,为实际应用提供参考对照价值。方法便利选取该院2018年1月—2020年1月所收治老年患者90例,根据随机数字表法,分为研究组和对照组。其中,对照组45例,在完善检查和对症治疗基础上,仅予以奥氮平进行治疗;研究组45例,在上述治疗基础上,加用MECT。记录两组患者治疗前后PANSS评分差异,并比较组间疗效差异。结果治疗前,两组患者PANSS评分对比,差异无统计学意义(P>0.05);治疗6周、12周后,研究组PANSS评分分别为(63.33±3.19)分、(40.12±3.07)分,均低于对照组,差异有统计学意义(t=11.154、12.155,P<0.05)。研究组中,显效17例、有效13例,总有效率为66.67%,高于对照组的12例、7例及42.22%,差异有统计学意义(χ^(2)=5.421,P<0.05)。研究组患者中,出现2例心动过速、13例体重增加、2例乏力及8例脑电图异常,其不良反应发生率为55.56%,与对照组的42.22%相比较,差异无统计学意义(χ^(2)=1.111,P>0.05)。结论在对症治疗、单纯使用奥氮平治疗基础上,进一步加用MECT可更好控制患者精神症状。对改善临床疗效具有积极,且联合治疗后不良反应较少,不会给患者造成额外机体损伤,使用安全性较高。

Objective To explore the curative effect of non-convulsive electroconvulsive(MECT)in the treatment of refractory schizophrenia in the elderly,and to provide reference for practical application.Methods A total of 90 elderly patients admitted to the hospital from January 2018 to January 2020 were selected and divided into study group and control group according to the random number table method.Among them,45 cases in the control group were treated with olanzapine only on the basis of perfect examination and symptomatic treatment;45 cases in the study group were treated with MECT on the basis of the above treatment.The difference in PANSS scores between the two groups of patients before and after treatment was recorded,and the difference in efficacy between the groups was compared.Results Before treatment,compared with the PANSS scores of the two groups of patients,the difference was not statistically significant(P>0.05);after 6 weeks and 12 weeks of treatment,the PANSS scores of the study group were(63.33±3.19)points and(40.12±3.07)points,respectively,all lower than the control group,and the difference was statistically significant(t=11.154,12.155,P<0.01).In the study group,17 cases were markedly effective and 13 cases were effective.The total effective rate was 66.67%,which was higher than the 12 cases,7 cases and 42.22%of the control group,the difference was statistically significant(χ^(2)=5.421,P<0.05).In the study group,2 cases of tachycardia,13 cases of weight gain,2 cases of fatigue and 8 cases of EEG abnormalities occurred in the study group.The adverse reaction rate was 55.56%.Compared with 42.22%in the control group,the difference was not statistically significant(χ^(2)=1.111,P>0.05).Conclusion On the basis of symptomatic treatment and olanzapine treatment alone,the further use of MECT can better control the patients'mental symptoms.It is positive for improving clinical efficacy,has fewer adverse reactions after combined treatment,will not cause additional body damage to patients,and has high safety in use.