電休克治療(定稿)

1、A Free sample background from Slide 1 浙江省科學(xué)技術(shù)廳重大項目 編號：2013T301-19抑郁癥和老年期癡呆防治技術(shù)成果轉(zhuǎn)化工程A Free sample background from Slide 2主要內(nèi)容A Free sample background from Slide 3 一、電休克治療及歷史A Free sample background from Slide 4A Free sample background from Slide 5A Free sample background from Slide 6ECT發(fā)展史年限治療者治療方法1

2、934年Meduna(匈牙利)樟腦酊1935年 1938年Lazlo Meduna(18961964)戊四氮化合物1938年Ugo Cerletti(1877-1963)Lucio Bini(1908-1964)(意大利)電休克電抽搐電痙攣1940年 Bennett改良電抽搐A Free sample background from Slide 7ECT和mECT的比較ECTmECT適用范圍小大操作過程簡單較復(fù)雜（通電前靜脈推注阿托品、麻醉劑、肌松劑）抽搐發(fā)作表現(xiàn)全身強烈抽搐局部輕微抽搐療效好好并發(fā)癥骨折多見少A Free sample background from Slide 8國外ECT

3、使用情況A Free sample background from Slide 9國內(nèi)mECT使用情況A Free sample background from Slide 10二、ECT適應(yīng)癥A Free sample background from Slide 11A Free sample background from Slide 12A Free sample background from Slide 13A Free sample background from Slide 14A Free sample background from Slide 15A Free sample

4、 background from Slide 16ECT禁忌癥A Free sample background from Slide 17A Free sample background from Slide 18A Free sample background from Slide 19特殊人群的ECT治療A Free sample background from Slide 20特殊人群的ECT治療A Free sample background from Slide 21mECT的療效A Free sample background from Slide 22mECT的安全性A Free

5、 sample background from Slide 23A Free sample background from Slide 24mECT的副作用A Free sample background from Slide 25mECT治療過程中的并發(fā)癥A Free sample background from Slide 26A Free sample background from Slide 27A Free sample background from Slide 28A Free sample background from Slide 29三、ECT/mECT的實施A Free

6、 sample background from Slide 30A Free sample background from Slide 31A Free sample background from Slide 32A Free sample background from Slide 33A Free sample background from Slide 344、禁食A Free sample background from Slide 35l但是，也有報道患者在進(jìn)早餐后2.5小時行mECT導(dǎo)致了反流誤吸、呼吸暫停。l精神病患者是相對特殊的群體，不易配合且處于高應(yīng)激狀態(tài)，嚴(yán)格禁食是否合理

7、還有待討論。A Free sample background from Slide 365、mECT治療過程中的心電監(jiān)測A Free sample background from Slide 376、mECT治療過程中腦電圖監(jiān)測A Free sample background from Slide 387、ECT/mECT的典型分期A Free sample background from Slide 39A Free sample background from Slide 408、ECT/mECT的護理A Free sample background from Slide 419、治療后的

8、護理A Free sample background from Slide 42A Free sample background from Slide 43四、操作技術(shù)參數(shù) 非優(yōu)勢半球單側(cè)-dElia位（1970）和Muller 位（1971） 雙側(cè) 單側(cè)、雙側(cè)療效相等；可逆性的認(rèn)知損害，單 側(cè) 少于雙側(cè) 電極放置在大腦運動區(qū)外表頭皮部位 房間濕度、頭皮接觸部位清潔度影響電阻 電極靠攏、導(dǎo)電膠多易短路A Free sample background from Slide 44電極雙側(cè)、單側(cè)放置的位置示意圖A Free sample background from Slide 45A Free

9、sample background from Slide 46A Free sample background from Slide 47初始1月 2月5月6月復(fù)發(fā)1次/周41次/10天3天1次/2周61次/2周2并抗抑郁治療維持治療A Free sample background from Slide 48五、治療相關(guān)藥物及注意事項A Free sample background from Slide 49A Free sample background from Slide 50A Free sample background from Slide 51A Free sample background from Slide 52mECT中藥物相互作用A Free sample background from Slide 53A Free sample background from Slide 54A Free sample background from Slide 55電休克治療流程選擇病員選擇病員通報科主任通報科主任家屬知情同意家屬知情同意檢查檢查