南方医科大学学报

南方医科大学学报 ›› 2026, Vol. 46 ›› Issue (1): 104-112.doi: 10.12122/j.issn.1673-4254.2026.01.11

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超级电休克在难治性抑郁中应用的临床研究：一项回顾性研究

安建雄1,2,3(), 迟智佳3, 赵彩群3, 李永祥3, 王若国3, 胡亚楠1,2()   

  1. 1.中国科学院大学医学院，北京 101408
    2.南方医科大学中西医结合医院麻醉科，广东 广州 510282
    3.山东第二医科大学附属医院疼痛与睡眠中心，山东 潍坊 261000
  • 收稿日期:2025-07-15 出版日期:2026-01-20 发布日期:2026-01-16
  • 通讯作者: 胡亚楠 E-mail:anjianxiong@yeah.net;huyanan1998@yeah.net
  • 作者简介:安建雄，教授，博士生导师，E-mail: anjianxiong@yeah.net
  • 基金资助:
    国家重点研发计划(2024YFC2510200)

Efficacy and safety of super electroconvulsive therapy for treatment-resistant depression: a retrospective analysis of 292 cases

Jianxiong AN1,2,3(), Zhijia CHI3, Caiqun ZHAO3, Yongxiang LI3, Ruoguo WANG3, Yanan HU1,2()   

  1. 1.School of Medicine, University of Chinese Academy of Sciences, Beijing 101408, China
    2.Department of Anesthesiology, Hospital of Integrated Traditional Chinese and Western Medicine, Southern Medical University, Guangzhou 510282, China
    3.Affiliated Hospital of Shandong Second Medical University, Weifang 261000, China
  • Received:2025-07-15 Online:2026-01-20 Published:2026-01-16
  • Contact: Yanan HU E-mail:anjianxiong@yeah.net;huyanan1998@yeah.net

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摘要：

目的 比较多次电刺激下显著延长癫痫波发作的超级电休克（super ECT）对难治性抑郁的治疗疗效。 方法 基于人群的队列研究纳入2024年12月~2025年6月接受super ECT的难治性抑郁患者292例。根据一次super ECT中电击次数分为3组：E1组为一次ECT过程电击1次（n=88），E2组为一次ECT过程电击2次（n=89），E3组为一次ECT过程电击3次（n=39）。分析基线抑郁、焦虑和失眠量表评分之间的相关性。首次疗程后第1、3、6个月利用汉密尔顿抑郁量表-17（HAMD-17）评估抑郁症状，基于减分率比较3组治疗缓解率和反应率。比较6个月内治疗次数，再住院率和不良反应发生率。分析首次super ECT治疗时的脑电图（EEG）癫痫波发作持续时间。 结果 E1组74例（84.09%）、E2组76例（76.40%）、E3组32例（82.05%）患者在super ECT后6个月内达到缓解。在6个月内super ECT治疗疗程在E1组为2.13±1.44次，E2组为2.23±2.01次，E3组为2.41±2.15次。基线HAMA、HAMD-17和PSQI评分相关（P<0.001）。第1次癫痫波发作时间在E1组显著高于E2和E3组（P<0.001）。E2组3个月和6个月的再住院率高于E1组（P=0.012、0.026）。短期不良反应包括发热、头痛/头晕、全身痛和口干。 结论 super ECT作为该领域的技术创新方法在>180 s的发作时间下具备临床安全性和有效性。一次麻醉下电击次数对治疗效果无明显影响。

关键词: 超快速抗抑郁, 超级电休克, 难治性抑郁

Abstract:

Objective To evaluate the efficacy and safety of super electroconvulsive therapy (ECT) for treatment-resistant depression (TRD). Methods This cohort study was conducted among 292 patients with TRD, who received super ECT from December, 2024 to June, 2025. Eighty-eight of the patients received one electrical stimulation in each super ECT procedure (E1 group), 89 had 2 electrical stimulations (E2 group), and 39 had 3 electrical stimulations (E3 group). The correlation between depression, anxiety and sleep quality at baseline was analyzed. The patients were evaluated using 17-items Hamilton Depression Scale (HAMD-17) at 1, 3, and 6 months after the first super ECT session, and the treatment remission rate and response rate were compared among the 3 groups. The number of sessions and incidences of adverse events within 6 months were compared, and the EEG seizure duration at the first super ECT session was analyzed. Results Seventy-four patients (84.09%) in group E1, 76 (76.40%) in group E2, and 32 (82.05%) in group E3 achieved remission within 6 months after super ECT. The average number of treatment sessions was 2.13±1.44 in Group E1, 2.23±2.01 in Group E2, and 2.41±2.15 in Group E3 within 6 months. The baseline HAMA, HAMD-17 and PSQI scores were significantly correlated (P<0.001). The first seizure duration in E1 group was significantly longer than that in E2 and E3 groups (P<0.001). The rehospitalization rates were significantly higher in E2 group than in E1 group at 3 months (P=0.012) and 6 months (P=0.026). The short-term adverse effects included fever, headache/dizziness, general pain and dry mouth. Conclusion Super ECT is safe and effective for treatment of TRD patients with a total seizure duration longer than 180 s. The number of electrical stimulations in each treatment session does not significantly affect the therapeutic efficacy of super ECT.

Key words: ultra-rapid antidepressant, super electroconvulsive therapy, treatment-resistant depression