摘要： 探讨运动锻炼和心理治疗相结合的护理方法，对老年脑卒中后抑郁患者心理康复疗效的影响。共80 例脑卒中后抑郁患者分为康复治疗组和常规治疗组，分别于入院时和入院后3 个月进行日常生活活动能力（Barthel指数）和抑郁状态［汉密尔顿抑郁量表（HAMD，17 项）］评价。结果显示，入院时康复治疗组与常规治疗组之间Barthel 指数［58.69（51.57，57.40）对59.02（55.15，61.27）］和HAMD 评分［13.52（10.87，15.02）对13.85（10.50，14.42）］，差异无统计学意义（P > 0.05）；治疗3 个月后康复治疗组患者Barthel 指数［71.28（69.20，73.02）对58.31（57.53，63.37）］和HAMD 评分［8.05（7.32，10.78）对14.98（12.68，17.80）］明显改善，与常规治疗组之间差异有统计学意义（P < 0.05）。提示运动锻炼、心理康复与药物治疗相结合有利于缓解脑卒中后抑郁症状，促进神经功能恢复，改善预后。

关键词: 卒中, 抑郁, 身体锻炼, 心理疗法, 康复护理

Abstract: Objective  To investigate the influence of rehabilitation nursing including psychological counseling and exercise training on post?stroke depression patients. Methods  Eighty patients with post-stroke depression were divided into 2 groups: rehabilitation group (combination of conventional drug treatment and auxiliary exercise and phychological therapy, N = 40) and control group (drug and auxiliary exercise therapy, N = 40). These patients were assessed by using Barthel Index (BI) and Hamilton Depression Rating Scale (HAMD) on admission and 3 months after treatment respectively.  Results  There was no statistically significant difference in the BI and HAMD score between rehabilitation group and control group on admission [BI: 58.69 (51.57, 57.40) vs 59.02 (55.15, 61.27), HAMD: 13.52 (10.87, 15.02) vs 13.85 (10.50, 14.42); P > 0.05]. After 3 months' treatment, the ability of daily living was obviously improved and HAMD score decreased in rehabilitation group, and the differences with control group were statistically significant [BI: 71.28 (69.20, 73.20) vs 58.31 (57.53, 63.37); HAMD: 8.05 (7.32, 10.78) vs 14.98 (12.68, 17.80); P < 0.05].  Conclusion  Combination of exercise training, psychological rehabilitation and drug treatment is beneficial for alleviating post-stroke depression and improving the recovery of neurological function and prognosis.

Key words: Stroke, Depression, Exercise movement techniques, Psychotherapy, Rehabilitation nursing