无抽搐电休克用于难治性精神分裂症中的可行性(1)
[摘要] 目的 探讨无抽搐电休克治疗难治性精神分裂症的临床效果。方法 整群选取并回顾分析该院2012年12月—2014年6月接受治疗的55例难治性精神分裂症患者临床资料，所有患者均基于原有抗精神病药物基础上实施无抽搐电休克治疗，比较患者治疗前、后各指标变化情况。结果 治疗1周(77.23±22.15)分、4周(70.25±22.83)分、8周(68.37±22.74)分后患者的PANSS评分明显比治疗前(88.72±25.23)分低，且治疗1 d后，患者背数记忆(7.1±3.2)分、再认(6.9±2.9)分、联想(6.7±3.2)分等指标比治疗前有所降低，差异有统计学意义(P<0.05)。但治疗1、4、8周与治疗前背数记忆、再认、图片、联想等四项指标差异无统计学意义(P>0.05)。结论 难治性分裂症患者给予无抽搐电休克治疗，通过定量电流对患者大脑产生一定的刺激，具有良好的治疗效果，虽然对记忆有短暂性影响，但值得在临床上大力推广应用。
[关键词] 无抽搐电休克；难治性精神分裂症；效果
[中图分类号] R749.3 [文献标识码] A [文章编号] 1674-0742(2016)04(c)-0093-03
[Abstract] Objective To discuss the clinical effect of modified electric convulsive therapy in treatment of refractory schizophrenia. Methods The clinical data of 55 cases of patients with refractory schizophrenia treated in our hospital from December 2012 to June 2014 were retrospectively analyzed， and all patients were treated with modified electric convulsive therapy on the basis of primary antipsychotics， and the changes of various indexes of patients before and after treatment were compared. Results The PANSS scores of patients after 1 week， 4 weeks and 8 weeks of treatment were respectively (77.23±22.15)， (70.25± 22.83) and (68.37± 22.74)， which were obviously lower than those before treatment， (88.72±25.23)， and the indexes including reciting number memory， recognition and association after 1d of treatment were respectively (7.1±3.2)， (6.9±2.9) and (6.7± 3.2)， which were decreased compared with those before treatment， and the differences had statistical significance， P<0.05， the differences in the four indexes including memory， recognition， picture and association after 1 week， 4 weeks and 8 weeks of treatment and before treatment had no statistical significance， P>0.05. Conclusion For patients with refractory schizophrenia， the modified electric convulsive therapy has a good treatment effect by generating a certain stimulus to the patient’s brains through the quantitative current， even though it has a temporary effect on the patient’s memory， it is worth great promotion and application in clinic.
[Key words] Modified electric convulsive therapy； Refractory schizophrenia； Effect
难治性精神分裂症是精神科比较常见的病症，既往研究表明，约有30%～50%精神分裂症患者对药物治疗效果不理想，最终发展为难治性病例[1]。无抽搐电休克(MECT)是传统电休克治疗方法的改良形式，因其具有治疗效果好、安全性高、起效快等优点，从而在临床中得到广泛应用。该次试验以该院2012年12月—2014年6月收治的55例患者展开研究，探讨难治性精神分裂症患者给予MECT治疗的临床效果，现报道如下。
1 资料与方法
1.1 一般资料
该次试验纳入的难治性精神分裂症的患者，其诊断是依据Kane1996年创建的，即过去5年对3种药物剂量和疗程适当的抗精神病药物(3种药物至少有2种化学结构是不同的)治疗反应不良。整群选取2012年12月—2014年6月在该院收治的55例难治性精神分裂症患者为研究对象，上述患者均符合ICD-10诊断标准中精神分裂症各项指标，患者阳性与阴性症状量表总分60分[2]。其中，男性31例，女性24例，患者的年龄为19～70例，平均年龄为(43.19±10.05)岁，病程为5～19年，平均病程为(8.7±5.2)年，住院次数为3～17次，平均为(5.9±2.3)次。所有患者及家属均同意此次研究，签署相应的知情同意书。 (魏敏 黄少雅 陈旭先 邓泓 郑榕艳 林瑞钱 陈明钟)
[关键词] 无抽搐电休克；难治性精神分裂症；效果
[中图分类号] R749.3 [文献标识码] A [文章编号] 1674-0742(2016)04(c)-0093-03
[Abstract] Objective To discuss the clinical effect of modified electric convulsive therapy in treatment of refractory schizophrenia. Methods The clinical data of 55 cases of patients with refractory schizophrenia treated in our hospital from December 2012 to June 2014 were retrospectively analyzed， and all patients were treated with modified electric convulsive therapy on the basis of primary antipsychotics， and the changes of various indexes of patients before and after treatment were compared. Results The PANSS scores of patients after 1 week， 4 weeks and 8 weeks of treatment were respectively (77.23±22.15)， (70.25± 22.83) and (68.37± 22.74)， which were obviously lower than those before treatment， (88.72±25.23)， and the indexes including reciting number memory， recognition and association after 1d of treatment were respectively (7.1±3.2)， (6.9±2.9) and (6.7± 3.2)， which were decreased compared with those before treatment， and the differences had statistical significance， P<0.05， the differences in the four indexes including memory， recognition， picture and association after 1 week， 4 weeks and 8 weeks of treatment and before treatment had no statistical significance， P>0.05. Conclusion For patients with refractory schizophrenia， the modified electric convulsive therapy has a good treatment effect by generating a certain stimulus to the patient’s brains through the quantitative current， even though it has a temporary effect on the patient’s memory， it is worth great promotion and application in clinic.
[Key words] Modified electric convulsive therapy； Refractory schizophrenia； Effect
难治性精神分裂症是精神科比较常见的病症，既往研究表明，约有30%～50%精神分裂症患者对药物治疗效果不理想，最终发展为难治性病例[1]。无抽搐电休克(MECT)是传统电休克治疗方法的改良形式，因其具有治疗效果好、安全性高、起效快等优点，从而在临床中得到广泛应用。该次试验以该院2012年12月—2014年6月收治的55例患者展开研究，探讨难治性精神分裂症患者给予MECT治疗的临床效果，现报道如下。
1 资料与方法
1.1 一般资料
该次试验纳入的难治性精神分裂症的患者，其诊断是依据Kane1996年创建的，即过去5年对3种药物剂量和疗程适当的抗精神病药物(3种药物至少有2种化学结构是不同的)治疗反应不良。整群选取2012年12月—2014年6月在该院收治的55例难治性精神分裂症患者为研究对象，上述患者均符合ICD-10诊断标准中精神分裂症各项指标，患者阳性与阴性症状量表总分60分[2]。其中，男性31例，女性24例，患者的年龄为19～70例，平均年龄为(43.19±10.05)岁，病程为5～19年，平均病程为(8.7±5.2)年，住院次数为3～17次，平均为(5.9±2.3)次。所有患者及家属均同意此次研究，签署相应的知情同意书。 (魏敏 黄少雅 陈旭先 邓泓 郑榕艳 林瑞钱 陈明钟)