电休克治疗难治性精神分裂症的效果
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摘要
目的探讨电休克治疗难治性精神分裂症的临床效果。方法回顾性分析2017年1月～2018年6月我院收治的50例难治性精神分裂症患者的临床资料,按照治疗方案不同将其分为观察组(25例)和对照组(25例)。对照组患者给予利培酮治疗,观察组患者给予电休克治疗,比较两组患者的临床治疗效果、治疗前后阳性和阴性症状量表(PANSS)评分和威斯康辛卡片分类测验(WCST)结果变化情况以及治疗期间不良反应总发生率。结果观察组患者的治疗总有效率略高于对照组,但差异无统计学意义(P>0.05)。两组患者入院时的PANSS评分比较,差异无统计学意义(P>0.05);两组患者治疗后2、5、9周的PANSS评分均显著低于入院时,差异有统计学意义(P<0.05);观察组患者治疗后2、5、9周的PANSS评分均低于对照组,差异有统计学意义(P<0.05)。两组患者入院时的WCST情况比较,差异无统计学意义(P>0.05);两组患者治疗后9周的总测验次数、错误应答数、持续性错误数均显著低于入院时,完成分类数显著高于入院时,差异有统计学意义(P<0.05);观察组患者治疗后9周的总测验次数、错误应答数、持续性错误数均显著低于对照组,完成分类数显著高于对照组,差异有统计学意义(P<0.05)。两组患者治疗期间的不良反应总发生率比较,差异无统计学意义(P>0.05)。结论电休克治疗难治性精神分裂症的效果与利培酮相似,安全性均良好,但在改善患者阳性和阴性症状方面的效果更明显,值得临床推荐。
Objective To investigate the clinical effect of electroconvulsive shock in the treatment of refractory schizophrenia.Methods The clinical data of 50 patients with refractory schizophrenia treated in our hospital from January 2017 to June 2018 were retrospectively analyzed.They were divided into the observation group(25 cases) and the control group(25 cases) according to the different treatment schemes.The patients in control group were treated with Risperidone and the patients in observation group were treated with electroconvulsive shock.The clinical treatment effect,the positive and negative symptom scales(PANSS) scores and the changes in the Wisconsin card sorting test(WCST)results before and after treatment and the total incidence rate of adverse reactions during treatment were compared between the two groups.Results The total effective rate of the observation group was slightly higher than that of the control group,but the difference was not statistically significant(P>0.05).There were no significant differences in PANSS scores between the two groups at admission(P>0.05).The PANSS scores at 2,5,and 9 weeks after treatment in the two groups were significantly lower than those at admission,and the differences were statistically significant(P<0.05).The PANSS scores at 2,5,and 9 weeks after treatment of the observation group were lower than those of the control group,and the differences were statistically significant(P<0.05).There was no significant difference in the WCST between the two groups at admission(P>0.05).The total number of tests,the number of false responses and the number of persistent errors at 9 weeks after treatment in the two groups were significantly lower than those at admission,the number of completed classifications was significantly higher than that at admission,and the differences were statistically significant(P<0.05).The total number of tests,the number of false responses and the number of persistent errors at 9 weeks after treatment in the observation group were significantly lower than those in the control group,the number of completed classifications was significantly higher than that in the control group,and the differences were statistically significant(P <0.05).There was no significant difference in the total incidence rate of adverse reactions between the two groups during treatment(P>0.05).Conclusion The effect of electroconvulsive shock is similar to that of Risperidone in the treatment of refractory schizophrenia and both have fine safety.However,electroconvulsive shock is more effective in improving the positive and negative symptoms of patients,which is worthy of clinical recommendation.
Objective To investigate the clinical effect of electroconvulsive shock in the treatment of refractory schizophrenia.Methods The clinical data of 50 patients with refractory schizophrenia treated in our hospital from January 2017 to June 2018 were retrospectively analyzed.They were divided into the observation group(25 cases) and the control group(25 cases) according to the different treatment schemes.The patients in control group were treated with Risperidone and the patients in observation group were treated with electroconvulsive shock.The clinical treatment effect,the positive and negative symptom scales(PANSS) scores and the changes in the Wisconsin card sorting test(WCST)results before and after treatment and the total incidence rate of adverse reactions during treatment were compared between the two groups.Results The total effective rate of the observation group was slightly higher than that of the control group,but the difference was not statistically significant(P>0.05).There were no significant differences in PANSS scores between the two groups at admission(P>0.05).The PANSS scores at 2,5,and 9 weeks after treatment in the two groups were significantly lower than those at admission,and the differences were statistically significant(P<0.05).The PANSS scores at 2,5,and 9 weeks after treatment of the observation group were lower than those of the control group,and the differences were statistically significant(P<0.05).There was no significant difference in the WCST between the two groups at admission(P>0.05).The total number of tests,the number of false responses and the number of persistent errors at 9 weeks after treatment in the two groups were significantly lower than those at admission,the number of completed classifications was significantly higher than that at admission,and the differences were statistically significant(P<0.05).The total number of tests,the number of false responses and the number of persistent errors at 9 weeks after treatment in the observation group were significantly lower than those in the control group,the number of completed classifications was significantly higher than that in the control group,and the differences were statistically significant(P <0.05).There was no significant difference in the total incidence rate of adverse reactions between the two groups during treatment(P>0.05).Conclusion The effect of electroconvulsive shock is similar to that of Risperidone in the treatment of refractory schizophrenia and both have fine safety.However,electroconvulsive shock is more effective in improving the positive and negative symptoms of patients,which is worthy of clinical recommendation.
引文
[1]姚捷,陈正,粟幼嵩.难治性精神分裂症治疗研究进展[J].中国医药导报,2013,10(2):32-34.
[2]李广新,余逗逗,马利,等.难治性精神分裂症患者认知功能状况及危险因素的研究[J].国际精神病学杂志,2018,45(4):629-631,641.
[3]Gaebel W,Riesbeck M,Zielasek J,et al.Web-based field studies on diagnostic classification and code assignment of mental disorders:comparison of ICD-11 and ICD-10[J].Fortschr Neurol Psychiatr,2018,86(3):163-171.
[4]周景方.无抽搐电休克治疗难治性精神分裂症的有效性及不良反应[J].包头医学院学报,2016,32(9):91-92.
[5]司天梅,杨建中,舒良,等.阳性和阴性症状量表(PANSS,中文版)的信、效度研究[J].中国心理卫生杂志,2004,18(1):45-47.
[6]Hodges JR(英).熊丽(译).临床神经心理学认知评估手册(第2版)[M].武汉:华中科技大学出版社,2013:162-166.
[7]罗程,尧德中.精神分裂症物理治疗机制及其神经成像研究进展[J].四川精神卫生,2015,28(6):481-487.
[8]饶世雄,谭伟.无抽搐电休克与利培酮治疗难治性精神分裂症的临床效果对照研究[J].中国药物警戒,2014,11(10):580-583.
[9]谢金莲.无抽搐电休克治疗难治性精神分裂症合并心理干预的效果观察[J].实用临床护理学电子杂志,2018,3(15):145,154.
[10]孙梅玲,温东焕.难治性精神分裂症无抽搐电休克治疗前后认知功能的变化研究[J].黑龙江医药科学,2017,40(4):111-112.
[11]李启斌,陶领钢,石顺治,等.重复经颅磁刺激与无抽搐电休克联合利培酮治疗流浪难治性精神分裂症患者的临床对照研究[J].现代中西医结合杂志,2018,27(9):918-921,941.
[12]李广新,余逗逗,马利,等.难治性精神分裂症患者认知功能状况及危险因素的研究[J].国际精神病学杂志,2018,45(4):629-631,641.
[13]高天飞,张雄,苑杰.利培酮合并无抽搐电休克治疗难治性精神分裂症的临床效果探究[J].中国卫生标准管理,2016,7(17):98-100.
[14]李桦,吴荣琴,孙复林.无抽搐电休克维持治疗对难治性精神分裂症患者的疗效和认知功能的影响[J].临床精神医学杂志,2018,28(4):241-244.
[15]De Mel VN,Korman N,McArdle P,et al.Weight gain correlated with decrease in clozapine/N-desmethyl-clozapine ratio in a man with treatment-refractory schizophrenia[J].Australas Psychiatry,2018,26(5):558-559.
[16]刘华强.齐拉西酮缓释剂联合氯氮平对难治性精神分裂症患者认知功能的影响[J].四川解剖学杂志,2018,26(2):43-44,50.
[17]田佩瑶.利培酮合并无抽搐电休克治疗难治性精神分裂症的临床研究[J].中国现代药物应用,2017,11(1):104-106.
[18]陈圣丽,许勤伟,叶亮.帕利哌酮联合经颅磁刺激治疗难治性精神分裂症效果观察[J].山东医药,2018,58(34):86-88.
[19]张荣荣,闫伟,吕兰兰,等.精神分裂症首发及前驱期认知功能研究[J].中国医药导报,2018,15(13):42-46.
[20]周庆海.高频重复经颅磁刺激治疗精神分裂症难治性阴性症状的临床观察[J].当代医学,2018,24(8):59-61.
[2]李广新,余逗逗,马利,等.难治性精神分裂症患者认知功能状况及危险因素的研究[J].国际精神病学杂志,2018,45(4):629-631,641.
[3]Gaebel W,Riesbeck M,Zielasek J,et al.Web-based field studies on diagnostic classification and code assignment of mental disorders:comparison of ICD-11 and ICD-10[J].Fortschr Neurol Psychiatr,2018,86(3):163-171.
[4]周景方.无抽搐电休克治疗难治性精神分裂症的有效性及不良反应[J].包头医学院学报,2016,32(9):91-92.
[5]司天梅,杨建中,舒良,等.阳性和阴性症状量表(PANSS,中文版)的信、效度研究[J].中国心理卫生杂志,2004,18(1):45-47.
[6]Hodges JR(英).熊丽(译).临床神经心理学认知评估手册(第2版)[M].武汉:华中科技大学出版社,2013:162-166.
[7]罗程,尧德中.精神分裂症物理治疗机制及其神经成像研究进展[J].四川精神卫生,2015,28(6):481-487.
[8]饶世雄,谭伟.无抽搐电休克与利培酮治疗难治性精神分裂症的临床效果对照研究[J].中国药物警戒,2014,11(10):580-583.
[9]谢金莲.无抽搐电休克治疗难治性精神分裂症合并心理干预的效果观察[J].实用临床护理学电子杂志,2018,3(15):145,154.
[10]孙梅玲,温东焕.难治性精神分裂症无抽搐电休克治疗前后认知功能的变化研究[J].黑龙江医药科学,2017,40(4):111-112.
[11]李启斌,陶领钢,石顺治,等.重复经颅磁刺激与无抽搐电休克联合利培酮治疗流浪难治性精神分裂症患者的临床对照研究[J].现代中西医结合杂志,2018,27(9):918-921,941.
[12]李广新,余逗逗,马利,等.难治性精神分裂症患者认知功能状况及危险因素的研究[J].国际精神病学杂志,2018,45(4):629-631,641.
[13]高天飞,张雄,苑杰.利培酮合并无抽搐电休克治疗难治性精神分裂症的临床效果探究[J].中国卫生标准管理,2016,7(17):98-100.
[14]李桦,吴荣琴,孙复林.无抽搐电休克维持治疗对难治性精神分裂症患者的疗效和认知功能的影响[J].临床精神医学杂志,2018,28(4):241-244.
[15]De Mel VN,Korman N,McArdle P,et al.Weight gain correlated with decrease in clozapine/N-desmethyl-clozapine ratio in a man with treatment-refractory schizophrenia[J].Australas Psychiatry,2018,26(5):558-559.
[16]刘华强.齐拉西酮缓释剂联合氯氮平对难治性精神分裂症患者认知功能的影响[J].四川解剖学杂志,2018,26(2):43-44,50.
[17]田佩瑶.利培酮合并无抽搐电休克治疗难治性精神分裂症的临床研究[J].中国现代药物应用,2017,11(1):104-106.
[18]陈圣丽,许勤伟,叶亮.帕利哌酮联合经颅磁刺激治疗难治性精神分裂症效果观察[J].山东医药,2018,58(34):86-88.
[19]张荣荣,闫伟,吕兰兰,等.精神分裂症首发及前驱期认知功能研究[J].中国医药导报,2018,15(13):42-46.
[20]周庆海.高频重复经颅磁刺激治疗精神分裂症难治性阴性症状的临床观察[J].当代医学,2018,24(8):59-61.