心理疏导联合康复护理对脑卒中偏瘫伴抑郁患者的影响

Impact of Psychological Counseling Combined with Rehabilitation Nursing on Depression after Hemiplegic Stroke

目的探讨心理疏导联合康复护理对脑卒中偏瘫伴抑郁患者的影响。方法选取2014年3月—2016年3月哈尔滨医科大学附属第四医院收治的脑卒中偏瘫伴抑郁患者104例,采用随机数字表法分为对照组和治疗组,每组52例。在常规对症治疗基础上,对照组患者给予氟哌噻吨美利曲辛治疗,治疗组患者在对照组基础上给予心理疏导联合康复护理干预。比较两组患者干预前及干预后3、6周抑郁自评量表(SDS)评分,干预前后汉密尔顿抑郁量表(HAMD)各因子评分,干预前及干预后6、12周中国脑卒中临床神经功能缺损程度评分量表(CSS)评分,临床疗效。结果干预前两组患者SDS评分比较,差异无统计学意义(P>0.05);干预后3、6周治疗组患者SDS评分低于对照组(P<0.01)。干预前两组患者HAMD量表各因子评分比较,差异无统计学意义(P>0.05);干预后治疗组患者HAMD量表各因子评分低于对照组(P<0.01)。干预前两组患者CSS评分比较,差异无统计学意义(P>0.05);干预后6、12周治疗组患者CSS评分低于对照组(P<0.01)。治疗组患者总有效率为92.31%,高于对照组的76.92%(P<0.05)。结论心理疏导联合康复护理可有效减轻脑卒中偏瘫伴抑郁患者抑郁程度、改善其神经功能及临床疗效。

Objective To investigate the impact of psychological counseling combined with rehabilitation nursing on depression after hemiplegic stroke.Methods A total of 104 hemiplegic stroke patients complicated with depression were selected in the Fourth Hospital Affiliated to Harbin Medical University from March 2014 to March 2016,and they were divided into control group and treatment group according to random number table method,with 52 cases in each group.Based on conventional symptomatic treatment,patients in control group received flupenthixol and melitracen,while patients in treatment group received psychological counseling combined with rehabilitation nursing based on that of control group.SDS score before intervention,3 and 6 weeks after intervention,each factor score of HAMD before and after intervention,CSS score before intervention,6 and 12 weeks after intervention,and clinical effect were compared between the two groups.Results No statistically significant difference of SDS score was found between the two groups before intervention(P>0.05),while SDS score in treatment group was statistically significantly lower than that in control group 3 and 6 weeks after intervention,respectively(P<0.01).No statistically significant difference of each factor score of HAMD was found between the two groups before intervention(P>0.05),while each factor score of HAMD in treatment group was statistically significantly lower than that in control group after intervention,respectively(P<0.01).No statistically significant difference of CSS score was found between the two groups before intervention(P>0.05),while CSS score in treatment group was statistically significantly lower than that in control group 6 and 12 weeks after intervention(P<0.01).Total effective rate in treatment group was 92.31%,which was statistically significantly higher than that in control group of 76.92%(P<0.05).Conclusion Psychological counseling combined with rehabilitation nursing can effectively reduce the degree of depression after hemiplegic stroke,improve the neurological function and clinical effect.