娱乐康复治疗对卒中后抑郁及神经功能缺损改善的疗效分析

魏林枫陈妍丁宇杰陈美娟[]目的观察康复治疗对卒中后抑郁及神经功能缺损改善的影响。方法选择160例干预组则在此基础之上给予康复治疗。治疗前后分别采用Zung抑郁自评量表(SDS)、汉ysisoftheeffectivenessofrecreationrehabilitationtherapyondepressionandneurologicalimpairmentofpatientswithpost-strokedepression WEILing-feng,XIANGWei,CHENYan,DINGYu-jie,CHENMei-juan.ShanghaiJing’anGeriatricHospital,Shanghai ShanghaiMentalHealthCenter,ShanghaiJiaotongUniversity,Shanghai201108 ]Objective Thisresearchwasdesignedtoobservetheinfluenceofrecreationrehabilitationtherapyondepressionandneurologicalimpairmentofpatientswithpost-stroke Acase-controlstudyprogramwasused．Atotalof160eligiblehospitalizedpatient1swithpost-strokedepressionweredivedintorehabilitationgroupandcontrolgrouprandomly．Androutinetreatmentinrehabilitationdepartmentincludingdrugtherapy,exercisetherapyandphysicaltreatmentwerecarriedoutforbothgrouppatients．Besides,ofrehabilitationgroupwereprovidedrecreationrehabilitation．Then,allcaseswereevaluatedbyadoptingSDS,HAMD,NFDS,ADL．Results ScoresofSDS,HAMD,NFDSpatientsinrehabilitationgroupaftertreamentwerelowerthanthatofpatientsinthecontrolgroup．However,scoresofADLinrehabilitationgroupcaseswerehigherthanthatofthecontrolgroupcases. Recreationrehabilitationcanrelievedepression,improveneurological作者单位：200040市静安老年医院康复科（魏林枫）201108交通大学医学院附属精神卫生中心（，陈妍，丁宇杰，陈美娟*E-ofpatientswithpost-stroke cerebralapoplexy;post-strokedepression;neurologicalimpairment;recreation复治疗，旨在探讨该治疗对卒中后抑郁及神经功能恢复的影响。现如下：1对象与方法n（例（岁 病程（天卒中类型（例男女缺 头部CT或MRI证实,符合1995年中华第4届脑血管疾病学术会议制定的脑血n（例（岁 病程（天卒中类型（例男女缺 对照组给予神经内科常规干预(包括改善脑功能、降压、降脂及对症治 效康复的目的。上述康复治疗每天持续1小时，每周5天，连续治疗3月。娱家属、、陪护人员的加入。自评量表(SDS)、汉密顿抑郁量表(HAMD)(24项版本)、神经功能缺损程度评分指数(barthelindex，BI)评分，总分为100分，>60分为良(自理)，41分～60分为n干预 干预干预前 n干预 干预干预前 注：1与干预前比较，P<0．05；2与对照组比较，P<0．05第一种是反应性学说,认为由于卒中导致肢体瘫痪心理反应，这对抑郁PSD损害了一些情绪中枢或情绪的传导通路，导致脑内的生化递质特[科，1996，29：379-380。Ayerbe,L.,Ayis,S.,Wolfe,CD,etal.Naturalhistory,predictorsand ofdepressionafterstroke:Systematicreviewandmeta-ysis[J].BrJPsychiatry,2013,202(1):14–21.HackettML,AndersonCS.Frequencyofdepressionafterstroke:asystematicreviexofobservationalstudies[J].Stroke,2005,36(10):2296-2301.KIMJM,StewartR,BaeKY,etal.SerotonergicandBDNFgenesandriskofdepressionafterstroke[J].JAffectDisord,2012,136(3):833-840.YangSR,HuaP,ShangXY,etal.Predictorsofearlypostischemicstrokeapathyanddepression:across-sectionalstudy[J].BMCPsychiatry,2013,13(1):164.FangJ,ChengQ.Etiologicalmechanismsofpost-strokedepression:areview[J].NeurolRes,2009,31(9):904-909.金宁.文体疗法学.:华夏,2005:7-姜鹭春,胡永善,朱玉连,等.集体活动对脑卒中患者认知功能的影[J].中国康复,2008,23(3):258-赵福云,楚平华,闫景新.休闲康复对脑卒中患者抑郁及神经功能康复的影响[J].精神,2008,2l(6):457-460.SpechtJ,KingG,BrownE,eta1．Theimportanceofleisureinthelivesofswithcongenitalphysicaldisabilities[J]．AmJOccupTher,2002,Hartman-MaeirA,SorokerN,RingH,etal.Activities,participationandsatisfactionone-yearpoststroke[J].DisabilRehabil,2007,29(7):559-566.SorensenB,LukenK．Improvingfun