| Objective To improve the observation and statistical analysis of the survival status of patients after post-stroke depression(PSD)intervention,and to explain the role of PSD treatment and intervention in secondary prevention.It is expected that the diagnosis and treatment of PSD will be incorporated into the standardized secondary prevention of ischemic stroke,providing an adequate scientific basis for transitioning the disease from a purely therapeutic level to a mind-body approach.Methods In this research,patients with acute ischemic stroke who were admitted to the Department of Neurology of Inner Mongolia Baogang Hospital from November 2019 to October 2020 were selected as the research objects.Head CT and head nuclear magnetic examination were taken for risk factor assessment.In the meantime,corresponding treatment was provided in accordance with treatment guidelines for cerebrovascular diseases,and individualized secondary prevention was performed to patients.All patients at the early stage of new-onset ischemic stroke(one-week hospitalization)were scored with the Hamilton Depression Scale(HAMD),Mini Mental State Examination(MMSE),Montreal Cognitive Assessment(Mo CA)and Activity of Daily Living(ADL).A total of 322 cases of pure ischemic stroke were screened based on the consent of the patients and their families after the exclusion of mental disorders.According to the clinical interview results and HAMD score,120 cases were classified into the PSD group and 60 cases were classified into the non-PSD group,which were included in the experiment for treatment and observation.They were included in the experiment for treatment and observation after obtaining the consent of the patients and their family members.The PSD group was randomly divided into two groups on the basis of conventional antithrombotic therapy and psychological therapy,with 60 patients in the pharmaceutical treatment group treated with antidepressants(sertraline),and the other60 patients in the non-pharmaceutical treatment group,namely the control group,not treated with antidepressants.All patients returned in 1 month,3 months,and 6 months after the attack of the disease.They were treated with medicine,while their psychological changes were kept in observation,and their HAMD and National Institute of Health stroke scale(NHISS)were scored again.On the basis of this,the recovery of neurological function of patients in the PSD group and their compliance with drug treatment were evaluated.The difference between the recovery of neurological function in the treatment group and the control group,and the effect of early antidepressant treatment on the secondary prevention of ischemic stroke were also evaluated.It also evaluated the development of PSD in the patients in the non-PSD group at 3months and 6 months,as well as the correlation between the infarct sites and the occurrence of depression in the PSD group and the non-PSD group.Results The positive effect of long-term prognosis on PSD patients in the pharmaceutical treatment group was much higher than that of the control group.When scored on the corresponding scale again,the non-pharmacological treatment group presented aggravated degree of depression and neurological deficits,compared with the pharmacological treatment group.The difference was statistically significant(P<0.05),but there was no statistically significant difference in the effect of stroke recurrence between the pharmacological treatment group and the non-PSD group(P>0.05).It shows that the early detection and treatment of PSD is helpful for secondary prevention and long-term prognosis.However,the NHISS score of patients in the non-pharmacological treatment group shows an upward trend during follow-up,which may indicate that PSD has a certain adverse effect on the long-term prognosis of PSD patients.After statistical analysis,infarction in most of the newly-attached PSD patients mainly concentrates in the basal ganglia,frontal lobe and thalamus.Moreover,in this research,patients in the non-PSD group who suffered from depression during the stroke recovery period also had strokes mainly in the basal ganglia,frontal lo be and thalamus.All of the above indicate that early recognition and early treatment of PSD patients have a significant effect on the secondary prevention of patients with cerebral infarction.Conclusions 1.Early identification and intervention of PSD have a positive clinical value for recovery of neurological deficits and improvement of quality of life in stroke patients.2.Early antidepressant treatment improves depression in patients with PSD.3.Early intervention increases compliance with treatment in patients with ischemic stroke.4.PSD is more likely to occur in people with cumulative stroke sites such as basal ganglia,frontal lobe,and thalamus.5.Post-stroke depression should be included in the secondary prevention of ischemic stroke to reduce the recurrence rate of ischemic stroke patients. |
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