刘琳　江妙玲　李雪珍

【摘要】 目的 探討精神科个性化干预护理对依托咪酯复合琥珀胆碱诱导的无抽搐电休克治疗后抑郁症患者的护理效果。方法 192例依托咪酯复合琥珀胆碱诱导的行无抽搐电休克治疗的患者， 随机分为对照组和实验组， 每组96例。对照组患者给予常规护理， 实验组患者则给予常规护理+个性化护理干预， 比较两组患者术后不良反应及汉密尔顿抑郁量表（HAMD）评分情况。结果 实验组患者头痛、肌痛、恶心呕吐、记忆减退例数分别为6例、2例、1例、3例， 对照组患者头痛、肌痛、恶心呕吐、记忆减退例数分别为15例、9例、7例、10例。实验组患者头痛、肌痛、恶心呕吐、记忆减退情况明显少于对照组， 差异均具有统计学意义（P<0.05）。护理前， 实验组患者的HAMD评分为（32.03±3.09）分， 对照组患者的HAMD评分为（32.29±3.14）分， 两组患者的HAMD评分比较， 差异无统计学意义（P>0.05）；护理后， 实验组患者的HAMD评分为（11.12±2.12）分， 对照组患者的HAMD评分为（18.34±2.28）分， 两组患者护理后的HAMD评分均低于护理前， 且实验组患者的HAMD评分低于对照组， 差异均具有统计学意义（P<0.01）。结论 精神科个性化干预护理对依托咪酯复合琥珀胆碱诱导的无抽搐电休克治疗后抑郁症患者的护理效果良好， 可以有效减少患者不良反应， 更加有效地缓解患者抑郁情况， 安全性较高， 具有借鉴性。

【关键词】 个性化干预护理；依托咪酯；琥珀胆碱；无抽搐电休克；抑郁症

DOI：10.14163/j.cnki.11-5547/r.2016.35.076

【Abstract】 Objective To explore nursing effect of psychiatric personalized nursing intervention in depression patients caused by etomidate compound succinylcholine induced modified electroconvulsive therapy. Methods A total of 192 patients treated by etomidate compound succinylcholine induced modified electroconvulsive therapy were randomly divided into control group and experimental group， with 96 cases in each group. The control group received conventional nursing， and experimental group received conventional nursing and personalized nursing intervention. Comparison were made on postoperative adverse reaction and Hamilton depression scale （HAMD） score. Results The experimental group had head pain， myalgia， nausea and vomiting and hypomnesia respectively as 6， 2， 1 and 3 cases， and the control group had head pain， myalgia， nausea and vomiting and hypomnesia respectively as 15， 9， 7 and 10 cases. The experimental group had less cases of head pain， myalgia， nausea and vomiting and hypomnesia than control group， and their differences had statistical significance（P<0.05）. Before nursing， the experimental group had HAMD score as（32.03±3.09）points， and the control group had HAMD score as（32.29±3.14）points， HAMD score had no statistically significant difference in two groups（P>0.05）. After nursing， the experimental group had HAMD score as（11.12±2.12）points and the control group had HAMD score as（18.34±2.28）points. Both groups had lower HAMD score after nursing than before nursing， and the experimental group had lower HAMD score than control group， and the difference had statistical significance（P<0.01）. Conclusion Psychiatric personalized nursing intervention shows significant nursing effect in depression patients caused by etomidate compound succinylcholine induced modified electroconvulsive therapy. This method can effectively decrease adverse reactions and relive depression of patients with high security and can be used for reference.

【Key words】 Personalized intervention nursing；Etomidate；Succinylcholine； Modified electroconvulsive therapy； Depression

抑郁症又称抑郁障碍， 属于心境障碍的一种， 主要以情绪低落为突出表现， 需要长期持续的抗抑郁药物治疗， 且治疗效果不理想， 难根治， 复发率高。如果用两种不同的抗抑郁药足量、足疗程后药物反应较差， 疗效不理想者， 临床称之为难治性抑郁症， 在此种情况下依托咪酯复合琥珀胆碱诱导的无抽搐电休克治疗逐渐在抑郁症的治疗中得到开展， 虽然治疗效果较好， 但是仍然存在一些不良反应， 如头痛、肌肉疼痛、心血管并发症、记忆障碍等， 因此有效科学的护理方式对无抽搐电休克患者十分必要。……