本文關(guān)鍵詞：腦外傷康復(fù)期并發(fā)失眠情況調(diào)查及心理干預(yù)在失眠治療中的作用　出處：《蘇州大學(xué)》2008年碩士論文　論文類型：學(xué)位論文

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【摘要】： 目的:對(duì)腦外傷(TBI)康復(fù)期患者并發(fā)失眠情況進(jìn)行調(diào)查,分析可能相關(guān)因素,并對(duì)部分患者進(jìn)行心理干預(yù),觀察對(duì)TBI康復(fù)期失眠癥的療效,以期對(duì)臨床評(píng)估,防治提供部分依據(jù)。 方法:(一)對(duì)143例TBI康復(fù)期患者以自行設(shè)計(jì)問卷收集一般情況及病史資料,并進(jìn)行了匹茲堡睡眠質(zhì)量指數(shù)量表(PSQI)、漢密頓抑郁量表(HAMD)、漢密頓焦慮量表(HAMA)、11分指數(shù)法疼痛評(píng)定(NRS-11)、日常生活活動(dòng)能力評(píng)定(ADL)及簡明精神狀態(tài)檢查(MMSE)。(二)將47名TBI康復(fù)期失眠癥患者隨機(jī)分為心理干預(yù)組(以下簡稱心理組)與藥物治療組(以下簡稱藥物組)分別給予心理干預(yù)和藥物治療,兩組干預(yù)前后分別進(jìn)行PSQI、HAMD、HAMA、NRS-11、ADL評(píng)定。 結(jié)果:(1)TBI康復(fù)期并發(fā)一種或多種失眠癥狀的有89例(62.2%),其中符合失眠癥診斷的有47例(32.9%)。(2)女性患者較男性患者(P＜0.05),輕度損傷患者較重度損傷患者(P＜0.01)失眠癥并發(fā)率高,年輕患者更易并發(fā)失眠癥(P＜0.05)。(3)TBI康復(fù)期并發(fā)失眠癥臨床表現(xiàn)以入睡困難、睡眠維持困難及主觀睡眠質(zhì)量差為主。(4)并發(fā)失眠癥組(CⅠ組)與無失眠癥組(NⅠ組)比較,疼痛指數(shù)(NRS-11)、日常生活活動(dòng)能力(ADL)及抑郁程度(HAMD)有明顯差異(P＜0.01)。(5)心理干預(yù)后患者HAMD、HAMA、NRS-11評(píng)分低于藥物組,ADL評(píng)分高于藥物組(P＜0.01)。(6)治療后心理干預(yù)組和藥物治療組療效無顯著差異,結(jié)束治療1月后前者PSQI總分及各因子分低于后者(P＜0.01),有效率和顯效率明顯高于后者(P＜0.05)。 結(jié)論:腦外傷康復(fù)期失眠發(fā)生率較高,高于一般人群;臨床上主要表現(xiàn)為入睡困難,睡眠維持困難及主觀睡眠質(zhì)量差;與之相關(guān)的因素可能有性別,外傷程度,疼痛及抑郁等;心理干預(yù)對(duì)TBI康復(fù)期失眠癥有較好的療效,并能緩解疼痛,改善負(fù)性情緒及促進(jìn)功能康復(fù),較之藥物治療療效更全面,更持久。
[Abstract]:Objective: To investigate the incidence of insomnia in patients with traumatic brain injury (TBI) during rehabilitation, analyze the possible related factors, and conduct psychological intervention on some patients, observe the efficacy of TBI in the treatment of insomnia in rehabilitation period, so as to provide some basis for clinical evaluation and prevention.
Methods: (a) in 143 cases of TBI patients with self-designed questionnaire to collect the general situation and history, and the Pittsburgh sleep quality index scale (PSQI), Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA), 11 index of pain assessment (NRS-11), daily life assessment of ability (ADL) and the mini mental state examination (MMSE). (two) 47 TBI convalescent insomnia patients were randomly divided into intervention group (hereinafter referred to as the psychological group) and treatment group (hereinafter referred to as the drug group) were given psychological intervention and drug treatment, PSQI, respectively, the two groups before and after intervention HAMD, HAMA, NRS-11, ADL assessment.
緇撴灉:(1)TBI搴峰鏈熷茍鍙戜竴縐嶆垨澶氱澶辯湢鐥囩姸鐨勬湁89渚，

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