急性脑梗死患者早期抑郁性障碍的临床特征及对其实施健康教育的效果
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摘要
目的:探究急性脑梗死患者早期抑郁心理障碍的临床特征及对其实施健康教育的效果。方法:选取2014年2月至2017年2月于我院就诊的急性脑梗死早期抑郁患者240例,将患者随机分为观察组(n=120)和对照组(n=120),对照组给予常规治疗,观察组在此基础上给予患者健康教育。对比两组患者治疗前后的HAMD、HAMA、Barthel指数及MMSE评分,对比两组患者治疗后的SF-36评分和满意度。结果:治疗后,两组患者HAMD和HAMA评分均有明显降低,且观察组明显优于对照组(t=-9.721,-10.428;P<0.01);两组患者Barthel指数和MMSE评分均有明显上升,且观察组明显优于对照组(t=4.820,11.847;P<0.01);观察组RP、RE、VT、BP、MH及GH这6个维度评分明显高于对照组(t=9.586,13.409,9.478,8.718,8.856,9.606;P<0.01)。观察组满意度明显高于对照组(χ~2=9.390,P<0.01)。结论:急性脑梗死患者早期抑郁性心理障碍的临床表现主要以精神症状为主,患者会出现明显焦虑和抑郁症状,认知能力较差,且生活能力下降。对患者实施健康教育能明显缓解患者焦虑和抑郁的程度,提高患者认知能力和生活质量。
Objective:To explore the clinical characteristics of early depressive mental disorders in patients with acute cerebral infarction and effects of health education.Methods:A total of 240 patients with cerebral infarction and early depression treated in the hospital from February 2014 to February 2017 were selected.They were randomly divided into the observation group(n=120)and the control group(n=120).The control group were given conventional treatment,and on this basis,the observation group were given health education.Scores of HAMD,HAMA,Barthel index and MMSE were compared between the two groups before and after treatment.The SF-36 scores before and after treatment and satisfaction were also compared between the two groups.Results:The total scores of HAMD and HAMA and scores of all factors in both groups were significantly decreased after treatment,and they were significantly better in the observation group than in the control group(t=-9.721,-10.428;P<0.01).Both Barthel index and MMSE scores in both groups were significantly increased after treatment(P<0.01),and they were significantly better in the observation group than in the control group(t=4.820,11.847;P<0.01).Scores of RP,RE,VT,BP,MH and GH in the observation group were significantly higher than those in the control group(t=9.586,13.409,9.478,8.718,8.856,9.606;P<0.01),and the satisfaction of the observation group was also significantly higher than that of the control group(χ~2=9.390,P<0.01).Conclusion:The main clinical manifestations of early depressive mental disorders in patients with acute cerebral infarction are mental symptoms.Patients may have obvious anxiety and depressive symptoms,with poor cognitive ability and decreased ability to live.The application of health education can significantly relieve the degree of anxiety and depression and improve patients' cognitive ability and quality of life.
Objective:To explore the clinical characteristics of early depressive mental disorders in patients with acute cerebral infarction and effects of health education.Methods:A total of 240 patients with cerebral infarction and early depression treated in the hospital from February 2014 to February 2017 were selected.They were randomly divided into the observation group(n=120)and the control group(n=120).The control group were given conventional treatment,and on this basis,the observation group were given health education.Scores of HAMD,HAMA,Barthel index and MMSE were compared between the two groups before and after treatment.The SF-36 scores before and after treatment and satisfaction were also compared between the two groups.Results:The total scores of HAMD and HAMA and scores of all factors in both groups were significantly decreased after treatment,and they were significantly better in the observation group than in the control group(t=-9.721,-10.428;P<0.01).Both Barthel index and MMSE scores in both groups were significantly increased after treatment(P<0.01),and they were significantly better in the observation group than in the control group(t=4.820,11.847;P<0.01).Scores of RP,RE,VT,BP,MH and GH in the observation group were significantly higher than those in the control group(t=9.586,13.409,9.478,8.718,8.856,9.606;P<0.01),and the satisfaction of the observation group was also significantly higher than that of the control group(χ~2=9.390,P<0.01).Conclusion:The main clinical manifestations of early depressive mental disorders in patients with acute cerebral infarction are mental symptoms.Patients may have obvious anxiety and depressive symptoms,with poor cognitive ability and decreased ability to live.The application of health education can significantly relieve the degree of anxiety and depression and improve patients' cognitive ability and quality of life.
引文
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[15]居海艳,吴婕,周建梅.早期系统化康复护理对急性脑梗死伴抑郁症状患者的临床效果分析[J].山西医药杂志,2016,45(22):2720-2722
[16]徐世英.早期系统化康复护理在老年急性脑梗死后抑郁症中应用[J].辽宁中医药大学学报,2014,16(11):187-188
[17]王绣芳.早期康复护理对急性脑梗死患者神经功能的影响[J].河北医药,2013,35(9):1437-1438
[18]王莹.早期心理护理干预对急性脑梗死患者心理状态改变的影响[J].齐鲁护理杂志,2014,20(17):24-25
[19]张龑敏.早期心理护理干预对急性脑梗死患者抑郁情绪的影响[J].齐齐哈尔医学院学报,2014,35(18):2774-2775
[20]王传凤,车手梅,闫璐璐,等.愉悦因子输入对急性脑梗死患者负性情绪和生活质量的干预效果观察[J].实用临床医药杂志,2015,19(8):111-112
[2]麻晓军,罗利飞.急性脑梗死患者治疗前后血清白细胞介素-68和10水平的变化及意义[J].中国药物与临床,2015,15(1):40-41
[3]傅照平,贺传沙,瞿仑学.氟西汀对急性脑梗死患者抑郁及功能康复的疗效研究[J].检验医学与临床,2015,12(5):651-653
[4]王华,孙文利,潘亚英,等.综合性护理干预对脑梗死患者焦虑抑郁及预后的影响[J].国际精神病学杂志,2015,42(3):64-67
[5]平萍,巴春贺,张鸿霞,等.低频重复经颅磁刺激辅助药物治疗老年脑梗死后焦虑抑郁患者的效果[J].中国临床保健杂志,2018,21(1):55-58
[6]简文佳,时晶,倪敬年,等.日常生活能力量表鉴别痴呆与轻度认知损害[J].中国老年学杂志,2014,34(4):865-868
[7]叶瑞繁,耿庆山,陈剑,等.3种焦虑评定量表在综合医院门诊患者中的应用比较[J].中华行为医学与脑科学杂志,2013,22(3):271-273
[8]刘浩,张鸿燕,肖卫东,等.5种抑郁症状评定工具评估精神分裂症患者抑郁症状的比较[J].中国心理卫生杂志,2015,29(8):570-575
[9]宋玉新.院前急救护理干预对高血压性脑出血患者神经功能的影响[J].医药与保健,2014,22(9):104-104
[10]刘剑,张小年,张慧丽,等.重度颅脑创伤恢复期简易精神状态检查及影响因素的研究[J].中国康复理论与实践,2014,20(4):367-370
[11]陈杰,田慧军.针灸联合氟西汀对急性脑梗死伴抑郁患者神经功能、负性情绪及免疫功能的影响[J].针灸临床杂志,2017,33(7):32-35
[12]孙莉莉,臧运华,唐明,等.三级综合护理对脑梗死患者神经功能和抑郁情绪的影响[J].中国中医急症,2014,23(4):776-778
[13]郑龙.氟西汀对老年急性脑梗死后抑郁患者神经功能缺损的影响[J].中国老年学杂志,2013,33(19):4841-4842
[14]孙杨梅.早期系统化康复护理对急性脑梗死伴抑郁患者抑郁症状和神经功能缺损的康复效果观察[J].临床医药文献电子杂志,2017(99):19495-19497
[15]居海艳,吴婕,周建梅.早期系统化康复护理对急性脑梗死伴抑郁症状患者的临床效果分析[J].山西医药杂志,2016,45(22):2720-2722
[16]徐世英.早期系统化康复护理在老年急性脑梗死后抑郁症中应用[J].辽宁中医药大学学报,2014,16(11):187-188
[17]王绣芳.早期康复护理对急性脑梗死患者神经功能的影响[J].河北医药,2013,35(9):1437-1438
[18]王莹.早期心理护理干预对急性脑梗死患者心理状态改变的影响[J].齐鲁护理杂志,2014,20(17):24-25
[19]张龑敏.早期心理护理干预对急性脑梗死患者抑郁情绪的影响[J].齐齐哈尔医学院学报,2014,35(18):2774-2775
[20]王传凤,车手梅,闫璐璐,等.愉悦因子输入对急性脑梗死患者负性情绪和生活质量的干预效果观察[J].实用临床医药杂志,2015,19(8):111-112