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目的探讨早期心理治疗对卒中后抑郁症发生率、病情严重程度及预后的影响。方法选择脑卒中无明显失语与认知功能障碍,无明显精神障碍史的患者200例,分为观察组和对照组各100例,对照组采用传统的治疗方案,观察组在传统治疗方案基础上给予心理治疗,采用HAMD法评估患者的抑郁情况,采用NHISS及BI方法评估患者的神经功能缺损程度及日常生活能力。结果 (1)对照组卒中后2个月抑郁症的发生率48%(48/100);观察组抑郁症的发生率32%(32/100),差异有统计学意义(P<0.05);(2)观察组卒中后2个月轻度抑郁15例,中度抑郁12例,重度抑郁5例;对照组卒中后2个月轻度抑郁10例,中度抑郁24例,重度抑郁14例,差异有统计学意义;(3)二组治疗前相比,对照组和观察组NHISS和BI均差异无统计学意义(P>0.05);治疗后二组患者NHISS较治疗前明显下降,BI得分较治疗前明显升高,差异均有统计学意义(P<0.05);二组治疗后相比,观察组NHISS较对照组明显升高,BI较对照组明显升高,差异均有统计学意义(P<0.05)。结论早期心理治疗可以一定程度的预防及改善卒中后抑郁症,改善患者的神经功能及日常活动能力,改善患者的预后。
Objective To investigate the effect of early psychotherapy on the incidence of post-stroke depression, severity and prognosis. Methods 200 stroke patients with no obvious aphasia and cognitive dysfunction were enrolled in the study. There were 200 patients in the observation group and the control group, 100 patients in the control group and the control group, respectively. The control group was treated with conventional therapy Psychological treatment was given. HAMD was used to evaluate the depression of patients. NHISS and BI methods were used to evaluate the degree of neurological deficits and daily living ability. Results (1) The incidence of depression was 48% (48/100) in the control group two months after stroke. The incidence of depression in the observation group was 32% (32/100), the difference was statistically significant (P <0.05). (2) In the observation group, there were 15 cases of mild depression at 2 months after stroke, 12 cases of moderate depression and 5 cases of severe depression. In the control group, 10 cases of mild depression at 2 months after stroke, 24 cases of moderate depression and 14 cases of severe depression (P <0.05); (3) The NHISS and BI in the control group and the observation group were not significantly different between the two groups before treatment (P> 0.05) (P <0.05). Compared with the control group, NHISS of the observation group was significantly higher than that of the control group, BI was significantly higher than the control group, the difference was statistically significant Significance (P <0.05). Conclusion Early psychological treatment can prevent and improve post-stroke depression to a certain extent, improve the neurological function and daily activities of patients, and improve the prognosis of patients.