抗精神病药物合并无抽搐电休克治疗难治性精神分裂症临床研究.docVIP

抗精神病药物合并无抽搐电休克治疗难治性精神分裂症临床研究 【摘要】 　　目的 探讨抗精神病药物合并无抽搐电休克 治疗 难治性精神分裂症的临床疗效及安全性。 方法 对60例难治性精神分裂症患者在原服用抗精神病药物治疗的基础上联合无抽搐电休克治疗，观察12 w。于合并治疗前及治疗第1 w、4 w、12 w末采用阳性与阴性症状量表、韦氏记忆量表、副反应量表评定临床疗效及不良反应。 结果 治疗12 w末总有效率为83.3%。治疗各时段阳性与阴性症状量表评分均较合并治疗前显著下降（P＜0.05或0.01），副反应量表评分均无显著性变化，韦氏记忆量表的再认、图片、联想及背数等4个项目评分在合并治疗第1 d末较治疗前显著下降（P＜0.01），但1 w、2 w末与治疗前无显著性差异（P＞0.05）。结论 抗精神病药物合并无抽搐电休克治疗难治性精神分裂症疗效显著，安全性高，依从性好，虽对记忆有短时 影响 ，但这种影响是可逆性的。 【关键词】 无抽搐电休克；难治性精神分裂症；联合治疗 　　A clinical study of antispychotics plus modified electroconvulsive therapy in treatmentrefractory schizophrenia 　　【Abstract】 Objective To understand the efficacy and side effects of modified electroconvulsive therapy （MECT）in treatmentrefractory schizophrenia(TRS). Methods 60 TRS patients on antipsychotics were added to MECT for 12 weeks.Clinical efficacies were assessed with the Positive and Negative Syndrome Scale (PANSS) and Wechsler Memory Scale (WMS), and adverse effects with the Treatment Emergent Symptoms Scale (TESS) before treatment and at the ends of the 1st,4th and 12th week treatment,respectively. Results At the end of the 12th week, the total effective rate was 83.3%. The PANSS scores lowered more significantly in each timesection during treatment compared with pretreatment(P0.05 or 0.01) and there was no significant change in the TESS score; scores of recognition, card, association and reciting in the WMS lowered more significantly in the 1st day of treament compared with pretreatment(P0.01), but there were no significant differences at the ands of the 1st and 2nd week from pretreatment(P0.05). Conclusion Antipsychotics plus MECT have significant effectiveness, higher safety and better compliance in treatmentresistant schizophrenia, even if it has transcient impact on memory which is reversible. 　　【Keywords】 Modified electroconvulsive therapy； refractory schizophrenia；combined treatment 　　无抽搐电休克（MECT）治疗精神分裂症近年来已在国内精神科临床广泛 应用 ，但有关MECT治疗难治性精神分裂症（TRS）的 研究 报道较少。我们应用MECT合并抗精神病药物治疗难治性精神分裂症取得了良好的疗效，现报告如下。 　　1 对象与方