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  [摘要] 目的：探讨心理护理对脑卒中后抑郁患者功能康复的影响。方法：对30例脑卒中后抑郁患者在早期康复治疗基础上采取心理护理，护理前后分别进行汉密顿抑郁量表、神经缺损功能评分、Fug-Meyer量表及改良Barthel指数评定。结果：护理前后患者各项指标比较，差异有统计学意义。结论：心理护理能改善脑卒中后抑郁症状，能消除患者的不良心理，积极配合功能训练，促进神经缺损功能恢复，提高躯体运动功能及日常生活活动能力。

 [关键词] 脑卒中；抑郁；心理护理；康复

 [中图分类号] R473.5 [文献标识码] A [文章编号] 1674-4721(2012)01(b)-146-02

 Influence of functional rehabilitation about depression patients after cerebrovascular disorder treated with psychological care

 HAN Bing, CHANG Yanyan, HAN Huiping

 Department of Neurology, Zhengzhou People's Hospital of Henan Province, Zhengzhou 450003, China

 [Abstract] Objective: To investigate the influence of functional rehabilitation about depression patients after cerebrovascular disorder treated with psychological care. Methods: Thirty cases of depression patients after cerebrovascular disorder rehabilitation took on the basis of psychological care based on the rehabilitation treatment in the early time, the Hamilton Depression Scale, Nerve defect function score, Fug-Meyer Scale and modified Barthel Index assessment were analyzed before and after nursing. Results: The comparison of the indicators in patients before and after care, difference was statistically significant. Conclusion: Psychological care for depression patients after cerebrovascular disorder can improve the depression symptom, eliminate the patient's adverse psychological, actively cooperate with functional training, promote functional recovery of nerve defects, improve motor function and physical activities of daily living.

 [Key words] Cerebrovascular disorder; Depression; Psychological care; Rehabilitation

 脑卒中是当今世界对人类健康有严重危害，致死率致残率较高的疾病之一，该类患者病后很多伴有心理障碍，脑卒中后抑郁是影响患者康复的主要原因。早期介入康复治疗，有效地减少了致残率，改善患者的生活质量，提高其生活自理能力。在日常临床工作中，笔者通过对此类患者的调查观察发现，脑卒中后抑郁症与心理障碍有以下因素有关：①和患病后致残程度有关；②和自身和他人心理支持有关；③和家庭社会支持力度有关。因此，本文通过在康复治疗过程中介入相应的心理护理，探讨对脑卒中康复治疗效果的影响。

 1 资料与方法

 1.1 一般资料

 选择本院2009年1月～2011年1月住院的脑卒中患者60例，男35例，女25例；年龄53～72岁，平均(53.21±10.76)岁；教育程度：小学文化15例，中学或中专文化24例，大专以上(含大专)21例；其中，脑梗死40例，脑出血20例；病变部位：额叶10例，颞叶3例，顶叶9例，枕叶4例，丘脑14例，基底节20例；病程：21～53 d，平均(32.31±8.79) d。入组标准：采用第四次全国脑血管病会议制定的脑卒中诊断标准[1]，全部患者经头颅CT或MRI检查证实；并符合全国精神疾病分类与诊断(CCMD-Ⅲ)中的抑郁症诊断标准 ......