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目的:探讨无抽搐电休克(Modified Electroconvulsive Therapy,MECT)治疗对儿童双相情感障碍躁狂发作患者临床疗效的影响。方法:将儿童双相情感障碍躁狂相患者42例,分为MECT+药物治疗组(A组,n=20)、药物治疗组(B组,n=22),于治疗前后及治疗后6月、12月、2年采用阳性与阴性症状量表(PANSS)、杨氏躁狂量表(YMRS)对两组患者进行评估。根据疗效评定标准计算有效率、复发率及再住院率。结果:A组治疗后、6月、12月、2年PANSS阳性因子及总分、YMRS总分明显低于B组(P<0.05)。随访6月、12月、2年,A组的有效率100%、100%、95%,B组的有效率68.18%、63.6%、50%,两组间差异有统计学意义(χ~2=7.636,8.984,10.395;P<0.01);A组的复发率5%、5%、10%,B组的复发率31.8%、40.9%、54.6%,两组间差异有统计学意义(χ~2=4.886,12.920,9.355;P<0.05);A组的再住院率5%、5%、10%,B组的再住院率18.2%,27.3%,31.8%,两组间相比差异无统计学意义。A组的复发和再住院累计生存曲线优于B组。复发的log-rankχ~2=9.140,再住院的log-rankχ~2=4.199(P<0.05)。且两组各时段药物不良率差异均无显著性。结论:合并ECT治疗对于儿童双相情感障碍躁狂发作的精神症状巩固十分重要,显著的降低了精神症状的复发及再住院率。
Objective: To investigate the effect of Modified Electroconvulsive Therapy (MECT) on the clinical efficacy of bipolar disorder in children with bipolar disorder. Methods: Forty-two patients with manic phase of bipolar disorder were divided into MECT + drug group (n = 20) and drug treatment group (n = 22), before and after treatment and after 6 months The two groups were evaluated in December and 2 years using positive and negative symptom scales (PANSS) and Young’s Mania Scale (YMRS). Efficacy, relapse rate and rehospitalization rate were calculated according to the efficacy evaluation criteria. Results: The total positive scores of PANSS, total score and YMRS in group A were significantly lower than those in group B after 6, 12 and 2 years (P <0.05). The follow-up was 6 months, 12 months and 2 years. The effective rates of group A were 100%, 100% and 95%, respectively. The effective rates of group B were 68.18%, 63.6% and 50%, respectively = 7.636,8.984,10.395; P <0.01). The recurrence rates of group A were 5%, 5% and 10%, and the recurrence rates of group B were 31.8%, 40.9% and 54.6%, respectively ~ 2 = 4.886,12.920,9.355; P <0.05). The rehospitalization rate was 5%, 5%, 10% in group A, 18.2%, 27.3% and 31.8% No statistical significance. A group of recurrence and rehospital cumulative survival curve was better than the B group. The log-rankχ ~ 2 = 9.140 for recurrence and log-rankχ ~ 2 = 4.199 for rehospitalization (P <0.05). There was no significant difference in the rate of drug failure between the two groups at each time point. CONCLUSIONS: The combination of ECT therapy is important for the consolidation of psychiatric symptoms of manic bipolar disorder in children, significantly reducing the recurrence and rehospitalization rates of psychiatric symptoms.