摘要
目的:脑卒中发生后医患双方均易忽略其精神症状,探讨早期评估和治疗脑卒中后精神障碍是否有助于患者预后。方法:山西医科大学第二医院神经内科收治,符合第四届全国脑血管病学术会议通过的诊断标准,并经头颅CT或头颅MRI检查证实,意识清醒,无严重智能障碍和失语的脑卒中急性期患者272例,采用统一标准对其进行躯体疾病轴及精神疾病轴的双轴诊断,对有精神障碍的发病组进行脑卒中常规和抗精神障碍双轴治疗,通过量化指标观察临床疗效,并对结果进行统计学处理。结果:通过双轴诊断发现脑卒中后精神障碍发病率为48.9%(133/272),其中以抑郁状态最多,占78.2%。且进行及时抗精神治疗后,精神症状缓解率分别为抑郁76.9%、焦虑85.0%、躁狂100%,并且发病组与未发病组的治愈率及有效率比较均差异无显著性意义(P>0.05)。结论:对脑卒中进行双轴诊断及双轴治疗,可以提高疗效,改善预后,具有重要的临床意义。
AIM:The mental symptoms of stroke patients are easy to be neglected by both the patients and the doctors after the occurrence of stroke,and the paper aims to explore whether early evaluation and mental disorder after treatment are good for the prognosis of the patients. METHODS:Totally 272 acute stroke patients with conciousness,but without serious intellectual disorder and anepia,who were treated in the Second Hospital of Shanxi Medical University and in accordance with the diagnostic criteria passed in the Fourth National Academic Meeting about Cerebrovascular Disease, were involved in the study.All the patients received the biaxial diagnosis of body and mental disease axises.The stroke routine and biaxial therapies against mental disorder were performed in the mental disorder group,the clinical effects were observed by quantitative indexes and the results were analyzed statistically. RESULTS:The biaxial diagnosis showed that the incidence rate of mental disorder after stoke was 48%(133/272),and the most common symptom was depression(78.2%).After the timely treatment against mental disorder,the remission rates of depression, anxiety and mania were 76.9%,85.0%,and 100%,and the curative rates and effective rate of the patients with stroke were not significantly different between the groups with and without mental disorder(P >0.05). CONCLUSION:The biaxial diagnosis and biaxial therapy can improve the effect and prognosis of the patients with stroke, which has important clinical significance.
出处
《中国临床康复》
CSCD
2004年第25期5220-5221,共2页
Chinese Journal of Clinical Rehabilitation
