Clinical Analysis Of Post Stroke Depression In Patients With Cerebral Infarction Treated By Intravenous Thrombolysis With Rt-PA At The End Of Three Months

Objective: This study collected information related to DaLian Medical University Department of Neurology in patients with cerebral infarction aims to describe rt-PA intravenous thrombolytic therapy for 3 months post-stroke depression the severity,analysis of possible influencing factors of post-stroke depression,and to explore the relationship between the different degree of depression factors and rt-PA intravenous thrombolytic therapy the influence of the patients with cerebral infarction.Methods: Methods the patients with first-ever cerebral infarction who were admitted to the Neurological Intensive Care Unit,DaLian Medical University from January 1,2016 to October 31,2016 were selected as the research object.Follow up of 3 months from lost and died after finally enrolled 103 patients,male 70 cases,female 33 cases,male to female ratio of 2.12:1.Age 28-90 years old,average age 63.88±11.30 years old.According to whether or not to accept rt-PA intravenous thrombolytic therapy were divided into thrombolytic group and non thrombolysis group(control group),the thrombolysis group 56 cases,non thrombolysis group 47 cases.According to the self-made questionnaire(homemade patients information collection table,homemade patients follow-up table)collecting clinical data of patients with all,and followed up for 3 months on it records of patients with 3 months after NIHSS(National Institutes of Health Stroke)scale,mRS(modified Rankin Scale)score,HAMD-17(Hamilton Depression Scale)score.According to whether or not to accept the differences of two groups were compared at baseline and thrombolytic therapy,the incidence and severity of depression of post-stroke depression in patients with cerebral infarction;explore related factors of post-stroke depression effect at the end of three months,the relationship between the different degree of depression and then compare the main influential factors and patients.SPSS19.0 software package was used to establish the database,and the data were analyzed by T test,Chi square test,Rank sum test,Single factor analysis and Multivariate conditional Logistic regression analysis.Results:1.There was no significant difference between 103 groups of patients with cerebral infarction(P>0.05).2.In 103 patients with cerebral infarction,There were 35 patients with post-stroke depression at the end of third months,The incidence was 33.98%.Among them,14 patients with post-stroke depression occurred in the end of the 3 month of thrombolysis group,the incidence of cerebral infarction in patients with cerebral infarction accounted for 13.59%,accounting for 25% of patients in the thrombolysis group;There were 21 patients with post stroke depression at the end of the 3 month in the non thrombolysis group,and the incidence rate was about 103 in the patients with cerebral infarction,accounting for about 44.68% of the patients in the non thrombolytic group.The thrombolysis group and non thrombolysis group at the end of the 3 month incidence of post-stroke depression were compared.The results showed that: Thrombolysis group without depression patients accounted for 103 cases of patients with cerebral infarction was significantly higher than non thrombolysis group and non thrombolysis group of depression patients accounted for 103 cases of cerebral infarction patients was significantly higher than the proportion of thrombolysis group.There was significant difference between the two groups in post stroke depression(P=0.031).3.In the selection of the possible impact on patients with cerebral infarction 3 months post-stroke depression of the 16 factors,including 3 factors: nursing staff(P=0.017),at the end of the 3 month mRS score(P=0.004)and intravenous thrombolysis thrombolytic therapy(P=0.013)is the influence factors of patients with cerebral infarction 3 months post-stroke depression.4.Family nursing care /workers care effect on patients with severe depression was statistically significant(P=0.002).The mRS score at the end of the 3 month of the patients had significant effects on mild,moderate and severe post stroke depression(P=0.006,P=0.000,P=0.000).The effect of thrombolytic therapy on patients with severe depression was statistically significant(P=0.045).The thrombolysis group,3 patients at the end of the mRS score in patients with mild,moderate and severe three different degrees of depression after stroke were studied,the difference was statistically significant(P=0.004,P=0.000,P=0.024);non thrombolysis group,family nursing care workers care / effect on patients with severe depression was statistically significant(P=0.007);at the end of the 3 month in patients with mRS score of mild,moderate and severe three different degrees of depression after stroke were studied,the difference was statistically significant(P=0.019,P=0.002,P=0.006).Conclusion:1.Rt-PA intravenous thrombolytic therapy can not only significantly reduce the incidence of post-stroke depression in patients with cerebral infarction at the end of 3 months,but also can significantly reduce the severity of post-stroke depression in patients with cerebral infarction at the end of 3 months.2.Nursing staff,3 month end mRS score and intravenous thrombolytic therapy were associated with PSD in patients with cerebral infarction at the end of 3 months.3.The main risk factors of post-stroke depression and depression after stroke: the relationship between the severity of different nursing personnel(family nursing / nursing care)in patients with cerebral infarction(especially non intravenous thrombolytic therapy in patients with cerebral infarction)at the end of the 3 month of severe depression after stroke is associated.The improvement of neurological function in patients with cerebral infarction at the end of 3 months was related to the occurrence of mild,moderate and severe depression at the end of 3 months.The treatment of acute cerebral infarction with thrombolytic therapy in patients with cerebral infarction at the end of 3 months after the onset of severe post-stroke depression.