摘要
目的：研究探讨脑卒中运动性失语患者发生抑郁的相关因素及护理干预方法。方法采用卒中后失语患者抑郁问卷-医院版（SADQ-H）对271例脑卒中运动性失语患者进行评分,分析脑卒中运动性失语患者抑郁的发生与一般情况、血管危险因素、卒中类型的相关性；将符合抑郁症诊断的166例患者进行波士顿失语症程度分级标准（BDAE）测评，分析脑卒中运动性失语患者抑郁的发生与失语程度的关系；按配对原则将抑郁患者分成2组分别进行护理干预，对照组83例进行神经内科常规护理；观察组83例进行系统化综合护理干预。干预4周后再次采用SADQ-H和BDAE对2组抑郁患者进行测评比较。结果脑卒中运动性失语患者抑郁的发生率为61.3%（166/271）。抑郁的发生与女性（χ2=5.580，P=0.02）、年龄≤60岁（χ2=4.390，P=0.04）、独居（χ2=5.400，P=0.02）、近期负性事件（χ2=4.420，P=0.04）有相关性，与非抑郁组比较差异有统计学意义（P＜0.05）。多因素Logistic回归分析显示女性（OR=2.58,95%CI 2.12～3.86，P<0.01）、年龄≤60岁（OR=2.62，95%CI 2.16～3.94，P<0.01）、独居（OR=2.59,95%CI 2.13～3.92，P<0.01）与抑郁的发生独立相关（P<0.01）。干预4周后观察组SADQ-H评分与对照组比较差异有统计学意义（t=2.94，P=0.002）；观察组BDAE失语程度治疗情况与对照组比较差异有统计学意义（χ2=14.045，P=0.000）。结论脑卒中运动性失语患者发生抑郁的主要相关因素为女性、年龄≤60岁、独居；失语程度越重越容易发生抑郁；对其进行早期护理干预，能改善患者的抑郁状态，促进患者语言功能的恢复。
Objective To explore the related factors and nursing interventional methods of depression in patients with motor aphasia after stroke. Methods The Stroke Aphasic Depression Questionnaire-Hospital version (SADQ-H) was used to diagnose depression of 271 patients with motor aphasia after stroke. The association of post-stroke depression with social factors, vascular risk factors and stroke features were analyzed. The relationship between depression severity and aphasia severity were analyzed. A total of 166 patients with depression were divided into the control group and the observation group to carry out different nursing interventional methods. Results The incidence of post-stroke depression in patients with motor aphasia was 61.3%(166/271). The occurrence of post-stroke depression was correlated with female (χ2=5.580, P=0.02) , age less than 60 years old (χ2=4.390, P=0.04) , living alone (χ2=5.400, P=0.02) , recent negative events (χ2=4.420, P=0.04). The multi-factor Logistic regression analysis showed that the occurrence of post-stroke depression was independently associated with female (OR=2.58, 95%CI 2.12-3.86, P<0.01), age less than 60 years old(OR=2.62, 95%CI 2.16-3.94, P<0.01), living alone(OR=2.59, 95%CI 2.13-3.92, P<0.01). After 4 weeks of nursing intervention, there were significant differences in SADQ-H scores (t=2.94, P=0.002) and distribution of Boston Diagnostic Aphasia Examination (BDAE) (χ2=14.045,P=0.000) between the control group and the observation group. Conclusions Female, ages less than 60 years old, living alone are independent risk factors of post-stroke depression in motor aphasia patients. The degree of depression is associated with aphasia severity. The early nursing intervention can improve the depression status and promote recovery of the language function of patients with motor aphasia after stroke.
出处
《中国实用护理杂志》
2016年第25期-,共4页
Chinese Journal of Practical Nursing
