电休克治疗(定稿)

1、A Free sample background from Slide 1 浙江省科学技术厅重大项目 编号：2013T301-19抑郁症和老年期痴呆防治技术成果转化工程A Free sample background from Slide 2主要内容A Free sample background from Slide 3 一、电休克治疗及历史A Free sample background from Slide 4A Free sample background from Slide 5A Free sample background from Slide 6ECT发展史年限治疗者治疗方法1

2、934年Meduna(匈牙利)樟脑酊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)电休克电抽搐电痉挛1940年 Bennett改良电抽搐A Free sample background from Slide 7ECT和mECT的比较ECTmECT适用范围小大操作过程简单较复杂（通电前静脉推注阿托品、麻醉剂、肌松剂）抽搐发作表现全身强烈抽搐局部轻微抽搐疗效好好并发症骨折多见少A Free sample background from Slide 8国外ECT

3、使用情况A Free sample background from Slide 9国内mECT使用情况A Free sample background from Slide 10二、ECT适应症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禁忌症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治疗A Free sample background from Slide 20特殊人群的ECT治疗A Free sample background from Slide 21mECT的疗效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治疗过程中的并发症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的实施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，也有报道患者在进早餐后2.5小时行mECT导致了反流误吸、呼吸暂停。l精神病患者是相对特殊的群体，不易配合且处于高应激状态，严格禁食是否合理

7、还有待讨论。A Free sample background from Slide 365、mECT治疗过程中的心电监测A Free sample background from Slide 376、mECT治疗过程中脑电图监测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的护理A Free sample background from Slide 419、治疗后的

8、护理A Free sample background from Slide 42A Free sample background from Slide 43四、操作技术参数 非优势半球单侧-dElia位（1970）和Muller 位（1971） 双侧 单侧、双侧疗效相等；可逆性的认知损害，单 侧 少于双侧 电极放置在大脑运动区外表头皮部位 房间湿度、头皮接触部位清洁度影响电阻 电极靠拢、导电胶多易短路A Free sample background from Slide 44电极双侧、单侧放置的位置示意图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月复发1次/周41次/10天3天1次/2周61次/2周2并抗抑郁治疗维持治疗A Free sample background from Slide 48五、治疗相关药物及注意事项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中药物相互作用A Free sample background from Slide 53A Free sample background from Slide 54A Free sample background from Slide 55电休克治疗流程选择病员选择病员通报科主任通报科主任家属知情同意家属知情同意检查检查