王颖等

[摘要] 目的 探讨综合性护理干预对西酞普兰治疗老年抑郁症的疗效及生活质量的影响。 方法 将2012年6月～2014年6月入住我院确诊的老年抑郁症患者84例作为观察对象，全部入选患者根据护理方法不同随机分为干预组和对照组，每组各42例，两组均予西酞普兰初始剂量20 mg，渐加量至40 mg，每日1次，口服，疗程6周。对照组患者行常规对症护理；干预组患者进行综合性护理干预，包括心理护理、用药护理、生活护理、安全护理、社会家庭支持干预、健康教育。 结果 治疗后，干预组的有效率为90.5%，对照组的有效率为73.8%，干预组的有效率显著高于对照组，且干预组的躯体功能、心理功能、社会功能、物质生活4个维度评分高于对照组，干预组HAMD评分低于对照组，差异具有统计学意义（P<0.05）。 结论 对应用西酞普兰治疗老年抑郁症实施综合性护理干预措施，可以提高疗效，改善患者的生活质量，值得推广和应用。

[关键词] 老年抑郁症；西酞普兰；综合性护理干预；生活质量

The affecting of comprehensive nursing intervention on effect and quality of life of citalopram in treatment of senile depression

WANG Ying XU Zhilou HOU Xianqin ZHANG Sujuan

Department of Psychiatry， Wenzhou Kangning Hospital in Zhejiang Province，Wenzhou 325000， China

[Abstract] Objective To investigate the effect and affecting of comprehensive nursing intervention on the quality of life of citalopram in the treatment of senile depression. Methods From June 2012 to June 2014 in our hospital diagnosed 84 patients with senile depression were selected as observation objects， all patients according to different nursing methods were randomly divided into intervention group and control group， 42 cases in each group， two groups were treated with citalopram initial dose 20 mg， gradually increased to 40 mg， 1 times daily orally a course of 6 weeks. The control group was treated with conventional symptomatic nursing for patients. The intervention group was treated with comprehensive nursing intervention， included psychological nursing， medication nursing care， life care， safety nursing， social and family support intervention， health education. Results After the treatment， the efficiency of intervention group was 90.5%， control group was 73.8%， the efficiency in the intervention group was significantly higher than that of control group， and the intervention groups physical function， psychological function， social function and material life of the 4 dimension score higher than those in the control group， the HAMD score of the intervention group was lower than that of the control group， with statistically significant differences（P<0.05）. Conclusion The comprehensive nursing intervention measures of citalopram in the treatment of senile depression can improve the curative effect， improve the quality of life of patients， is worthy of promotion and application.

[Key words] Senile depression； Citalopram； Comprehensive nursing intervention； Quality of life

老年抑郁症（senile melancholia）是一种常见的精神疾病，病程迁延，易反复发作，以持久而显著的心境低落为主要临床特征，可伴有烦躁不安、浑身燥热、潮红多汗等，严重者甚至有自杀念头和行为[1]。药物干预是缓解抑郁症患者症状、提高患者生活质量的有效手段，西酞普兰是一种治疗老年期抑郁症的安全有效的药物，其为选择性5-羟色胺（5-HT）再摄取抑制剂（SSRIs），其通过抑制5-HT再摄取，提高突触间隙5-HT浓度，增强5-HT传递功能而产生抗抑郁作用[2]。随着人口老龄化的加剧，老年抑郁症发病率越来越多，严重危害了老年人的身心健康。对老年抑郁症患者在应用西酞普兰治疗的同时实施综合性护理干预措施，重点做好心理干预，纠正患者不正确的认知，树立战胜疾病的信心，对提高疗效及老年人的生活质量具有重要的临床意义。……