住院精神病患者噎食特点分析

Analyzed the traits of choke incidents among the hospitalized psychotics

目的了解住院精神病患者发生噎食的临床特点。方法对2002年1月1日至2007年6月31日住院治疗期间发生噎食的患者的资料进行记录和统计,以查阅病历、访谈等方式获取资料并进行回顾性分析。结果65例患者共发生噎食71人次,其中男49人次(69·0%),女22人次(31·0%);平均年龄62岁,≥60岁者最多(62·0%)。诊断精神分裂症及妄想性障碍者噎食最多(76·0%),其次是器质性(包括症状性)精神障碍者(19·8%)。住院时间≥3个月者最常见(78·9%)。噎食在午餐最多(38·0%),其次是晚餐(29·6%)。噎食在饭厅发生的比例最高(70·4%)。最容易引起噎食的食物是面食(46·5%),其次是米饭(33·8%)。噎食最常用的抢救方法是汉姆立克操作(67·6%),和倒立法抢救有效率相比较差异有统计学意义(P>0·05)。噎食抢救成功67人次(94·4%),死亡4人次(5·6%)。结论精神科老年患者,长期住院和男性患者容易发生噎食,精神分裂症及器质性精神障碍者容易发生噎食。汉姆立克操作是比较常用的抢救方法,效果较好。精神科噎食致死率高。

Objective AIM To get the message the characteristics of the psychotics＇ choke during the hospitalization. Methods All the choke incidents recorded in the period from January 1,2002 to June 31,2007 were retrospectively analyzed for demographic variables, psychiatric diagnoses, inpatient time, happened place, time and the rescue method of choke. Results Collected 65 hospitalized psychotics who had choked 71 persontimes,among them, male 49 person-times （ 69.0% ） and female 22 person-times （ 31.0% ）. Mean age was 62 years old,over sixty years old were 44 person-times（62.0% ）. Most of the patients who choked were diagnosed schizophrenia/delusional disorders（ 76.0% ） and organic mental disorders（ 19.8% ）. Most of them were patients who stayed in hospital more than three months（78.9% ）. The choke incidents often take place during lunch （38.0%）and dinner（29.6% ）. Most choke happened at dinning room. The food which most easily caused choke were flour food （46.5%）and rice （33.8%）. The person-times of rescue choke successfully were 67 （94.4%） ,died 4 person-times （ 5.6% ）. About 67.7% psychotics use the Heimlich maneuver to rescue the choke and 95.8% choke symptoms gain improvements. Conclusion An increased risk of choke associated with psychiatric senile patients, long time hospitalization and male patients. Of the total, most psychotics＇ diagnosis were schizophrenia and organic mental disorders. Choke mainly occurred on the time of having meal, but were also seen on having snacks. The main choke food was staple food, especially when psychotics eat flour food and cooked rice. Most choke took place at dinning room,The Heimlich maneuver was used frequently and with good success. The mortality rate of choke was high.