氯胺酮麻醉的MECT对难治性抑郁症患者认知功能的影响

目的:探讨氯胺酮麻醉下的MECT治疗难治性抑郁症的安全性和治疗前后的认知功能变化。方法:入组60例需要MECT治疗的难治性抑郁症患者,随机分为氯胺酮组(30例)使用氯胺酮诱导麻醉的MECT治疗;异丙酚组(30例)使用异丙酚诱导麻醉的MECT治疗。入组患者在基线期及MECT治疗8次后完成汉密尔顿抑郁量表(HAMD)评定及连线测验AB、威斯康星卡片分类测验、汉诺塔测试,出组时评定副反应量表。结果:两组患者治疗结束后认知功能均较治疗前明显降低,异丙酚组较氯胺酮组降低更明显。结论:氯胺酮MECT治疗难治性抑郁症安全有效,对患者的认知功能损害较异丙酚组轻,未出现严重副作用。

The Cognitive Effects of Ketamine as Anesthesia on MECT in Patients with Refractory Depressive Disorder

Objective:To investigate the cognitive function defect of patients with TRD after ketamine-MECT.Methods:60 TRD inpatients were randomly divided into two groups: propofol-MECT group, and ketamine-MECT group. Both patients were asessed HAMD, Trail Making Test A&B, WCST, Tower of Hanoi before and after the eighth time of MECT, and TESS was examined at the end of MECT treatment.Results:HAMD score of the two groups were lower after MECT treatment respectively and reach the clinical recovery criterion. The cognitive function of patients in two groups were deteriorated remarkable, while which in propofol-MECT group were worse than that in ketamine-MECT group.Conclusion:Ketamine-MECT in treatment of TRD is safe and effectively, which cause the cognitive function damage of TRD patients is mildlier than propofol-MECT, and no serious side effect was observed.