娛樂(lè)康復(fù)治療對(duì)卒中后抑郁及神經(jīng)功能缺損改善的療效分析

魏林楓陳妍丁宇杰陳美娟[]目的觀察康復(fù)治療對(duì)卒中后抑郁及神經(jīng)功能缺損改善的影響。方法選擇160例干預(yù)組則在此基礎(chǔ)之上給予康復(fù)治療。治療前后分別采用Zung抑郁自評(píng)量表(SDS)、漢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作者單位：200040市靜安老年醫(yī)院康復(fù)科（魏林楓）201108交通大學(xué)醫(yī)學(xué)院附屬精神衛(wèi)生中心（，陳妍，丁宇杰，陳美娟*E-ofpatientswithpost-stroke cerebralapoplexy;post-strokedepression;neurologicalimpairment;recreation復(fù)治療，旨在探討該治療對(duì)卒中后抑郁及神經(jīng)功能恢復(fù)的影響?，F(xiàn)如下：1對(duì)象與方法n（例（歲 病程（天卒中類型（例男女缺 頭部CT或MRI證實(shí),符合1995年中華第4屆腦血管疾病學(xué)術(shù)會(huì)議制定的腦血n（例（歲 病程（天卒中類型（例男女缺 對(duì)照組給予神經(jīng)內(nèi)科常規(guī)干預(yù)(包括改善腦功能、降壓、降脂及對(duì)癥治 效康復(fù)的目的。上述康復(fù)治療每天持續(xù)1小時(shí)，每周5天，連續(xù)治療3月。娛家屬、、陪護(hù)人員的加入。自評(píng)量表(SDS)、漢密頓抑郁量表(HAMD)(24項(xiàng)版本)、神經(jīng)功能缺損程度評(píng)分指數(shù)(barthelindex，BI)評(píng)分，總分為100分，>60分為良(自理)，41分～60分為n干預(yù) 干預(yù)干預(yù)前 n干預(yù) 干預(yù)干預(yù)前 注：1與干預(yù)前比較，P<0．05；2與對(duì)照組比較，P<0．05第一種是反應(yīng)性學(xué)說(shuō),認(rèn)為由于卒中導(dǎo)致肢體癱瘓心理反應(yīng)，這對(duì)抑郁PSD損害了一些情緒中樞或情緒的傳導(dǎo)通路，導(dǎo)致腦內(nèi)的生化遞質(zhì)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.金寧.文體療法學(xué).:華夏,2005:7-姜鷺春,胡永善,朱玉連,等.集體活動(dòng)對(duì)腦卒中患者認(rèn)知功能的影[J].中國(guó)康復(fù),2008,23(3):258-趙福云,楚平華,閆景新.休閑康復(fù)對(duì)腦卒中患者抑郁及神經(jīng)功能康復(fù)的影響[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