综合康复治疗老年脑卒中并发抑郁症研究.docVIP

综合康复治疗老年脑卒中并发抑郁症研究 　　【摘要】 目的 观察疗养-医疗综合康复模式对老年脑卒中后并发抑郁症患者的治疗效果。方法选取2006年5月―2009年12月在沈阳军区大连疗养院桃源疗养区住院的60岁以上脑卒中并发抑郁症患者102例,随机分为综合康复治疗组(A组)和对照组(B组)各51例进行6个月的对照研究。两组均采用相同的神经内科治疗,A组在给予药物治疗的基础上还给予综合疗养康复治疗(包括健康宣教、运动、心理、高压氧、中医针灸、按摩、自然因子疗法等),B组给予一般神经内科药物治疗。使用Zung氏抑郁自评量表(SDS)及汉密顿抑郁量表(HAMD)评定康复治疗的效果。结果 A组在治疗3、6个月时经SDS及HAMD检测均有显著改善,差异有统计学意义(P0.05)。两组间差异有统计学意义(P 　　【关键词】 综合康复;老年人;脑卒中;抑郁症 　　【Abstract】Objective To observe the effect of comprehensive rehabilitation therapy (convalescence-medical treatment model)on cerebral stroke complicated with depression in elderly patients.Methods 102 patients with cerebral stroke complicated with depression over the age of 60 hospitalized from May 2006 to December 2009 were selected.All the patients were randomly divided into comprehensive rehabilitation treatment group(group A)and control group(group B),with 51 cases in each group.All patients were treated for 6 months.Both groups were accepted routine treatment.Group A was given comprehensive rehabilitation treatment on the basis of medication(including health education,exercise,psychological intervention,hyperbaric oxygenation,Chinese medicine acupuncture,massage and natural factors therapy etc).Group B was given drug treatment.The effects of treatment were assessed by using Zungs self-rating depression scale(SDS)and Yu stunning Hamilton scale(HAMD).ResultsThe indexes of SDS and HAMD in group A were significantly improved at 3,6 months after treatment,the differences were statistically significant(P8分,全部病例均符合1995年全国第4次脑血管病会议制定的诊断标准,并经头颅CT或MRI证实[4]。经急性期抢救后病情稳定,意识恢复;病程50分[5];汉密顿抑郁量表(HAMD)检测,评分17分评为抑郁症[6]。排除标准:凡有失语、恶性肿瘤,脑干及小脑病变、蛛网膜下腔出血者均不能入组,且无心、肝、肾功能障碍,血液病及精神障碍个人史。共入组102例,全部脑卒中并发抑郁症患者均由一人随机分为综合疗养康复组(A组)51例和一般治疗组(B组)51例。A组51例中,男42例,女9例;年龄61～82岁,平均(66±5.7)岁,病程3～45 d。B组51例中,男44例,女7例;年龄60～80岁,平均(65±5.9)岁,病程7～50 d。两组患者性别、年龄、病程及脑卒中类型等资料比较,差异无统计学意义(P0.05)。 　　1.2方法A组:给予药物治疗和综合疗养康复治疗。药物治疗:所有A组患者给予神经内科常规治疗,积极治疗原发病,控制高危因素。如溶栓抗凝,活血化瘀,脱水降颅内压,脑细胞保护剂等,调节血压、血糖、血脂,注意水电解质、酸碱平衡等。氟西汀抗抑郁治疗。综合疗养康复治疗:①健康宣教。让患者了解所