Objective To observe the effect of risperidone on improvement mental disorders induced by craniocerebral injury.Methods Totally 98 patients with craniocerebral injury from January 2012 to March 2015 were enrolled;among them,65 patients with mental disorders were randomly divided into observation group (33 cases) and control group (32 cases),the other 33 patients without mental disorders were as blank group.Routine treatment were used in all the patients.Observation group was orally given risperidone (initial dose 0.5 mg/time,2 times/d,gradually increased to 1 mg/time,2 times/d);control group was orally given sulpiride (initial dose 100 mg/time,3 times/d,gradually increased to 200-300 mg/time,3 times/d);the treatment lasted for 8 weeks.The National Institutes of Health Stroke Scale (NIHSS),Brief Psychiatry Rating Scale (BPRS) and Activities of Daily Living Scale (ADL) score before treatment and 2,4,8 weeks after treatment were compared among groups.Results The NIHSS and BPRS score were significantly higher,the ADL score was significantly lower in control group and observation group than those in blank group before treatment [(18.3 ±2.1),(18.2 ±2.4) scores vs (15.6±2.3) scores,(92.5 ±3.4),(92.3 ±3.6) scores vs (28.6 ±2.2) scores,(35 ±6),(34 ± 8) scores vs (43 ± 7) scores] (P ＜ 0.05),while were not significantly different between observation group and control group (P ＜ 0.05).Along with time,the NIHSS and BPRS score were gradually reduced and the ADL score was gradually increased,2,4 and 8 weeks after treatment,they were all significantly different with those before treatment [blank group:(11.5 ± 1.2),(8.4 ± 0.7),(6.2 ± 0.2) scores vs (15.6 ± 2.3) scores,(23.5±2.5),(19.5±1.7),18.2±1.3) scores,(53±10),(64±13),(82±13) scores;control group:(14.8±1.4),(12.1 ±1.4),(8.4 ±0.3) scores,(73.1 ±3.5),(37.2 ±2.5),(27.2 ±2.5) scores,(42±9),(55±11),(72±13) scores;observation group:(14.4±1.8),(10.4±1.6),(6.6±0.5) scores,(72.4±3.8),(31.4±2.3),(19.1±1.4) scores,(47±9),(63±12),(84±12) scores] (all P＜0.05);4 and 8 weeks after treatment,the NIHSS and BPRS score in observation group were significantly lower than those in control group,2,4 and 8 weeks after treatment,the ADL score in observation group was significantly higher than that in control group (P ＜ 0.05);8 weeks after treatment,the NIHSS,BPRS and ADL score in observation group were not significantly different with those in blank group (P ＞ 0.05) Conclusion Risperidone has good curative effect in craniocerebral injury patients with mental disorders,that in can promote nerve functional recovery,reduce mental score and improve life quality.%目的 观察利培酮改善颅脑损伤所致精神障碍的效果.方法 纳入2012年1月至2015年3月新疆医科大学附属中医医院神经外科收治的颅脑损伤住院患者98例,其中65例伴精神障碍,将其完全随机分为观察组(33例)及对照组(32例),余33例不伴精神障碍患者设为空白组.所有患者均行临床常规治疗;观察组口服利培酮(起始剂量0.5 mg/次,2次/d,逐渐增加至1 mg/次,2次/d),对照组口服舒必利(起始剂量100 mg/次,3次/d,逐渐增加至200 ～ 300 mg/次,3次/d),疗程均为8周.比较3组患者治疗前及治疗后2、4、8周美国国立卫生研究院卒中量表(NIHSS)、简明精神病评定量表(BPRS)评分及日常生活能力量表(ADL)评分.结果 对照组与观察组治疗前NIHSS、BPRS评分均高于空白组,ADL评分低于空白组[(18.3 ±2.1)、(18.2±2.4)分比(15.6±2.3)分,(92.5±3.4)、(92.3±3.6)分比(28.6±2.2)分,(35 ±6)、(34±8)分比(43 ±7)分](P＜0.05),对照组与观察组间差异无统计学意义(P＞0.05).随治疗时间延长,3组患者NIHSS和BPRS评分逐渐下降、ADL评分逐渐上升,治疗第2、4、8周[空白组:(11.5±1.2)、(8.4±0.7)、(6.2±0.2)分,(23.5±2.5)、(19.5±1.7)、(18.2±1.3)分,(53±10)、(64±13)、(82±13)分;对照组:(14.8±1.4)、(12.1±1.4)、(8.4±0.3)分,(73.1±3.5)、(37.2±2.5)、(27.2±2.5)分,(42 ±9)、(55±11)、(72±13)分;观察组:(14.4±1.8)、(10.4±1.6)、(6.6±0.5)分,(72.4±3.8)、(31.4±2.3)、(19.1±1.4)分,(47±9)、(63±12)、(84±12)分]与治疗前比较,差异均有统计学意义(均P＜0.05);治疗第4、8周观察组NIHSS和BPRS评分明显低于对照组,治疗第2、4、8周ADL评分明显高于对照组(P＜0.05),治疗第8周,观察组NIHSS、BPRS和ADL评分均接近空白组,差异无统计学意义(P＞0.05).结论 利培酮对颅脑损伤所致精神障碍患者具有良好疗效,能促进患者神经功能恢复、降低精神病相关评分、改善生存质量.
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