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目的:探讨心理治疗对急性脑卒中后患者抑郁及患肢功能恢复的辅助治疗的疗效。方法:选择首次发作脑卒中后患者90例,均在72 h内行头CT或MRI检查证实。存在偏瘫,偏瘫侧肢体肌力为0~2级,并且无严重认知功能障碍,言语交流无障碍。将其随机分成两组,对照组45例,采用常规药物治疗及肢体康复治疗;治疗组45例,在对照组治疗的基础上于入院第4天给予首次心理治疗,以后2次/每周的心理治疗。在第14、28天分别对患者进行抑郁自评量表(SDS)测量,同时对患肢肌力进行评价。结果:两组在不同时间抑郁自评量表(SDS)方面上比较差异有统计学意义(P<0.05);两组在不同时间肌力方面上比较差异有统计学意义(P<0.05);发病14 d与4 d及发病28 d与14 d(上、下)肢肌力、抑郁自评量表(SDS)方面分别比较差异均有统计学意义(P<0.05)。结论:在首次发作的脑卒中患者的早期积极的心理治疗可明显降低抑郁的发生,有利于患肢的功能恢复,降低脑卒中残疾的程度。
Objective: To investigate the effect of psychological therapy on patients with depression after stroke and adjuvant treatment of limb function recovery. Methods: Ninety patients were selected after the first episode of stroke, all of them were confirmed by CT or MRI within 72 hours. The presence of hemiplegia, hemiplegia lateral limb muscle strength of 0 to 2, and no serious cognitive dysfunction, verbal communication barrier-free. They were randomly divided into two groups, the control group of 45 cases, the use of conventional drug treatment and physical rehabilitation; treatment group of 45 patients on the basis of the control group on admission on the 4th day after giving the first psychological treatment, 2 / Psychotherapy. On the 14th and 28th days, the depression self-rating scale (SDS) was measured and the muscle strength of the limbs was evaluated. Results: There were significant differences in depression self - rating scale (SDS) between the two groups at different time points (P <0.05). There was significant difference between the two groups in muscle strength at different time points (P <0.05). There were significant differences in onset of 14 and 4 days, onset of 28 and 14 days (upper and lower) limb muscle strength, depression and self-rating depression scale (SDS) respectively (P <0.05). CONCLUSIONS: Early active psychotherapy in first-episode stroke patients can significantly reduce the incidence of depression, facilitate limb function recovery, and reduce the severity of stroke.