心理干预对老年脑卒中病人抑郁及神经功能康复的影响

Effects of Psychological Intervention on Post-stroke Depression and Neurological Rehabilitation in the Elderly

目的探讨心理干预对老年脑卒中后抑郁及神经功能康复的影响。方法将 12 0例老年脑卒中后抑郁病人随机分为观察组 (心理干预联合氟西汀及常规脑血管病治疗 )、对照 1组 (氟西汀联合常规脑血管病治疗 )及对照 2组(常规脑血管病治疗 )各 4 0例。分别于治疗前及治疗后第 2、4、8、12周末进行Hamilton抑郁量表 (HAMD)、神经功能缺陷及日常生活能力 (ADL)评定。结果经过 12周治疗后 ,观察组病人HAMD及神经功能缺陷评分均明显低于对照 1、2组 (P <0 .0 5或P <0 .0 1) ;ADL评分则明显高于对照 1、2组 (均P <0 .0 1)。结论心理干预不仅有助于改善老年脑卒中后抑郁 ,而且有利于病人神经功能的康复 ,提高其ADL。

Objective To explore the effects of psychological intervention on post-stroke depression and neurological rehabilitation in the elderly. Methods One hundred and twenty cases of post-stroke depression were divided into 3 groups: observation group (n=40) were subjected to psychological intervention, fluoxetine once every morning about 20 mg daily and the regular treatment of cerebrovascular disease; control 1 group (n=40) to fluoxetine once every morning about 20 mg daily and the regular treatment of cerebrovascular disease; control 2 group only to the regular treatment of cerebrovascular disease. All of cases were evaluated according to the HAMD score, neurological function impairment and ADL before treatment and 2nd, 4th, 8th, 12th week after the treatment. Results After treatment for 12 weeks, the scores of HAMD and the neurological function impairment in the observation group were lower than those in the control Ⅰ and Ⅱ groups (P<0.05 or P<0.01). The score of ADL in the observation group was higher than in the control Ⅰ and Ⅱ groups (P<0.01). Conclusion Psychological intervention is in favor of not only control the post-stroke depression in the elderly effectively, but also rehabilitating neurological function, improving the living ability.