摘要
目的 探讨依托咪酯与丙泊酚麻醉诱导无抽搐电痉挛治疗难治性抑郁症的临床疗效及安全性.方法 将60例接受无抽搐电痉挛治疗的难治性抑郁症患者随机分为两组,每组30例,分别应用依托咪酯与丙泊酚麻醉诱导,隔日1次,观察10次.于治疗前及治疗后1周、2周、4周、6周末采用汉密顿抑郁量表评定临床疗效,记录两组痉挛发作持续时间及能量抑制指数,记录治疗24 h内所发生的不良反应. 结果 无抽搐电痉挛首次及总体治疗后,依托咪酯组痉挛发作时间均较丙泊酚组延长,差异均有极显著性（P〈0.01）;治疗后两组汉密顿抑郁量表总分均较治疗前显著性下降,依托咪酯组治疗6周末较丙泊酚组下降更显著（P〈0.01）;两组不良反应多为轻、中度,患者均能耐受,发生率差异无显著性（P〉0.05）. 结论 无抽搐电痉挛治疗难治性抑郁症效果显著,采用依托咪酯作为麻醉诱导剂较丙泊酚麻醉诱导起效更快、疗效更好.
Objective To explore the clinical efficacy and safety of modified electroconvulsive therapy （MECT） induced by etomidate and propofol in treatment-resistant depression （TRD）. Methods Sixty TRD patients receiving MECT were randomized to two groups of 30 ones each, etomidate and propofol was respectively used to induce anesthesia q. o.d. for 10 times. Clinical efficacies were assessed with the Han- milton Depression Scale （HAMD） before treatment and at the end of the 1st, 2nd, 4th and 6th week, and the duration of seizure, energy inhibition index and adverse reactions within 24 hours after MECT recorded. Results After first-time and overall MECT, attack time prolonged more significantly in the etomidate than in the propofol group, differences were very significant （P〈0.01） ; after treatment, total HAMD scores of both groups lowered more significantly compared with pretreatment, so did in the former than in the lat- ter at the end of the 6th week （P〈0.01） ; Adverse reactions of both groups were mild to moderate, could be tolerated by all the patients, and their incidences had no significant differences （P〈0.05）. Conclusion MECT has an evident effect in treatment-resistant depression, etomidate as induction of anesthesia takes effect more rapidly and has better efficacy than propofol does.
出处
《临床心身疾病杂志》
CAS
2010年第6期487-489,共3页
Journal of Clinical Psychosomatic Diseases
