影响卒中后抑郁程度的相关因素及不同程度抑郁患者的治疗分析.docVIP

影响卒中后抑郁程度的相关因素及不同程度抑郁患者的治疗分析 　　【摘要】 目的：通过对102例卒中后抑郁患者的临床调查，分析影响卒中后抑郁程度的相关因素及不同程度抑郁患者的治疗。方法：对102例卒中后抑郁患者进行年龄、性别、职业、家庭关系、卒中次数、合并症（包括高血压、糖尿病、冠心病等）调查，应用Logistic回归探讨与抑郁程度相关的因素，同时应用抑郁自评表和汉密尔顿抑郁表对102例患者的抑郁程度进行评估，其中轻度抑郁者58例，中重度抑郁者44例。将轻度抑郁者分为试验组和对照组，每组各29例；中重度抑郁者分为试验组和对照组两组，每组各22例。试验组患者采用心理治疗和氟西汀联合治疗，对照组患者采用单纯心理治疗。治疗后通过采用社会支持评定表、中风病患者生存质量评定表和汉密尔顿抑郁量表进行疗效评价。结果：年龄、家庭关系、卒中次数和合并症是影响卒中后抑郁程度的相关因素，年龄越大、卒中次数越多、存在合并症会增高卒中后抑郁发生几率，家庭关系和睦有利于降低卒中后抑郁的发生；单纯心理治疗轻度抑郁患者疗效较好，试验组与对照组间临床疗效无差异，相对于中重度抑郁患者，试验组的临床疗效明显好于对照组，差异具有统计学意义（P0.05）。结论：年龄、家庭关系、卒中次数和合并症是影响卒中后抑郁程度的相关因素，对于轻度抑郁患者，单纯心理治疗就可取得较好疗效，对于中重度抑郁患者，心理治疗联合氟西汀的临床疗效优于单纯心理治疗。 　　【关键词】 卒中后抑郁程度； 相关因素； 不同程度； 抑郁患者； 治疗 　　【Abstract】 Objective： To analyze related factors affected the degree of depression after stroke and treatment of patients with varying degrees of depression by clinical investigation of 102 cases of depressions after stroke.Method： 102 cases of depressions after stroke of age， sex， occupation， family relationships， frequency of stroke，comorbidities （including hypertension， diabetes， coronary heart disease， etc.） were to investigated ， related factors of the degree of depression were explored by the application of Logistic regression，while applications of depression self-assessment form and Hamilton Depression table for 102 patients with the degree of depression were evaluated，then 58 cases of mild depression， moderate to severe depression were 44 cases. The mild and moderate to severe depression who were divided into two groups，29 cases in each mild depression groups and 22 cases in each moderate to severe depression groups.The experimental group of patients with psychological therapy and fluoxetine combination therapy，and the control group were treated with psychotherapy alone. After treatment， social support tables， stroke patients of quality of life assessment form and Hamilton Depression Scale for efficacy evaluation were used.Result： Age， family relations， and the number of stroke ，complications were related factors affe