中华老年多器官疾病杂志
中華老年多器官疾病雜誌
중화노년다기관질병잡지
CHINESE JOURNAL OF MULTIPLE ORGAN DISEASES IN THE ELDERLY
2014年
12期
887-890
,共4页
鲍枫%姜玮%李艳茹%侯冷冰%任艳萍
鮑楓%薑瑋%李豔茹%侯冷冰%任豔萍
포풍%강위%리염여%후랭빙%임염평
改良(无抽搐)电痉挛治疗%老年期抑郁%疗效%血压%心率
改良(無抽搐)電痙攣治療%老年期抑鬱%療效%血壓%心率
개량(무추휵)전경련치료%노년기억욱%료효%혈압%심솔
modified electroconvulsive therapy%elderly depression%efficacy%blood pressure%heart rate
目的：评价改良（无抽搐）电痉挛疗法（MECT）治疗老年期抑郁状态的疗效及对血压、心率的影响。方法选择2013年1月1日至2013年12月31日在首都医科大学附属北京安定医院MECT中心接受治疗的老年期抑郁患者70例，在药物治疗的基础上，联合给予MECT治疗6次。在治疗前、治疗3次后、治疗6次后进行汉密尔顿抑郁量表（HAMD）评估临床疗效；于首次MECT治疗前、麻醉后、发作后、发作后30min、发作后60min测量收缩压（SBP）、舒张压（DBP）和心率（HR）。结果 MECT治疗3次和6次结束时，HAMD评分与治疗前相比差异有统计学意义（均P＜0.01），有效率分别为80.0%和95.7%。麻醉后SBP、DBP明显下降，HR明显加快，与治疗前相比差异有统计学意义（均P＜0.01）；发作后SBP、DBP明显升高，HR明显加快，与治疗前相比差异有统计学意义（均P＜0.01）；发作后30min SBP、DBP明显升高，HR明显加快，与治疗前相比差异有统计学意义（均P＜0.01）；发作后60min SBP、DBP、HR恢复至治疗前水平（均P＞0.05）。结论 MECT联合药物治疗老年期抑郁患者，起效快，疗效好，值得在临床中广泛推广应用；在MECT治疗过程中，麻醉后血压下降，发作后血压明显增高，心率加快，约60min后恢复至治疗前水平，应持续观察。
目的：評價改良（無抽搐）電痙攣療法（MECT）治療老年期抑鬱狀態的療效及對血壓、心率的影響。方法選擇2013年1月1日至2013年12月31日在首都醫科大學附屬北京安定醫院MECT中心接受治療的老年期抑鬱患者70例，在藥物治療的基礎上，聯閤給予MECT治療6次。在治療前、治療3次後、治療6次後進行漢密爾頓抑鬱量錶（HAMD）評估臨床療效；于首次MECT治療前、痳醉後、髮作後、髮作後30min、髮作後60min測量收縮壓（SBP）、舒張壓（DBP）和心率（HR）。結果 MECT治療3次和6次結束時，HAMD評分與治療前相比差異有統計學意義（均P＜0.01），有效率分彆為80.0%和95.7%。痳醉後SBP、DBP明顯下降，HR明顯加快，與治療前相比差異有統計學意義（均P＜0.01）；髮作後SBP、DBP明顯升高，HR明顯加快，與治療前相比差異有統計學意義（均P＜0.01）；髮作後30min SBP、DBP明顯升高，HR明顯加快，與治療前相比差異有統計學意義（均P＜0.01）；髮作後60min SBP、DBP、HR恢複至治療前水平（均P＞0.05）。結論 MECT聯閤藥物治療老年期抑鬱患者，起效快，療效好，值得在臨床中廣汎推廣應用；在MECT治療過程中，痳醉後血壓下降，髮作後血壓明顯增高，心率加快，約60min後恢複至治療前水平，應持續觀察。
목적：평개개량（무추휵）전경련요법（MECT）치료노년기억욱상태적료효급대혈압、심솔적영향。방법선택2013년1월1일지2013년12월31일재수도의과대학부속북경안정의원MECT중심접수치료적노년기억욱환자70례，재약물치료적기출상，연합급여MECT치료6차。재치료전、치료3차후、치료6차후진행한밀이돈억욱량표（HAMD）평고림상료효；우수차MECT치료전、마취후、발작후、발작후30min、발작후60min측량수축압（SBP）、서장압（DBP）화심솔（HR）。결과 MECT치료3차화6차결속시，HAMD평분여치료전상비차이유통계학의의（균P＜0.01），유효솔분별위80.0%화95.7%。마취후SBP、DBP명현하강，HR명현가쾌，여치료전상비차이유통계학의의（균P＜0.01）；발작후SBP、DBP명현승고，HR명현가쾌，여치료전상비차이유통계학의의（균P＜0.01）；발작후30min SBP、DBP명현승고，HR명현가쾌，여치료전상비차이유통계학의의（균P＜0.01）；발작후60min SBP、DBP、HR회복지치료전수평（균P＞0.05）。결론 MECT연합약물치료노년기억욱환자，기효쾌，료효호，치득재림상중엄범추엄응용；재MECT치료과정중，마취후혈압하강，발작후혈압명현증고，심솔가쾌，약60min후회복지치료전수평，응지속관찰。
ObjectiveTo evaluate the efficacy of modified electroconvulsive therapy (MECT) in the treatment of elderly depression and investigate its effect on heart rate and blood pressure.Methods A total of 70 elderly patients with depression undergoing MECT in the MECT center of our hospital in the year of 2013 were recruited in this study. Beside drug treatment, they all finished 6 times of MECT. Hamilton Depression Scale (HAMD) was used to assess the clinical symptoms before, and in 3 and 6 times after treatment. Systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) were recorded before treatment, after anesthesia, and in 0, 30 and 60 min after convulsion.Results Significant differences were found in HAMD scores in all patients between pre-treatment and 3 or 6 times after MECT (allP<0.01), with an efficacy of 80.0% and 95.7% respectively. Compared with pre-treatment, SBP and DBP were significantly decreased while HR increased after anesthesia (allP<0.01); SBP, DBP and HR were significantly increased after convulsion (allP<0.01) and in 30 min after convulsion (allP<0.01). However, SBP, DBP and HR returned to the levels of pre-treatment in 60 min after convulsion (allP>0.05).Conclusion MECT combined with drug treatment is effective in the treatment of elderly depression, with rapid onset and good efficacy, and is worthy of being widely applied in clinical practice. In the process of MECT, blood pressure is reduced after anesthesia, and then obviously rises with HR after convulsion, but all these indices return to the levels before treatment in 60 min after convulsion. Continuous monitoring should be carried out during the whole process.
