躯体化障碍和未分化躯体形式障碍患者辅助检查项目和费用调查

Items and expense of accessory tests and examinations and related factors of somatization disorder and undifferentiated somatoform disorder

目的了解躯体化障碍和未分化躯体形式障碍患者辅助检查项目和费用及其相关因素。方法对115例躯体化障碍或未分化躯体形式障碍的患者,采用自编既往就诊检查情况调查表、自编躯体症状自评清单、症状自评量表、汉密尔顿焦虑量表和汉密尔顿抑郁量表进行评估。结果患者就诊前辅助检查总费用为72～10948元(中位数1068元);检查频度为1～53次(中位数9.0次);检查项目数为1～13项(中位数6.0项)。重复检查频度为0～44次(中位数3次),重复项目数为0～9项(中位数2项)。检查频度及重复频度较高的项目为血常规、B超、CT、尿常规、摄片、生化常规、MRI、心电图、粪常规。检查频度与病程、就诊科室数及HAMD总分均呈正相关(P<0.05),检查总费用与检查频度呈正相关(P<0.01)。结论躯体化障碍和未分化躯体形式障碍患者辅助检查种类多,重复检查多,应引起重视。

Objective： To investigate the items and expense of medical accessory tests and examinations and related factors of somatization disorder and undifferentiated somatoform disorder. Methods： One hundred and fifteen patients met CCMD - 3 diagnostic criteria for somatization disorder and undifferentiated somatoform disorder were included and assesses with self - edited past medical investigation inventory, self-edited self-rating somatic symptom list, symptom checklist 90, Hamilton anxiety scale and Hamilton depression scale. Results： Before the definition of the diagnosis, the total expense of medical tests and examinantios ranged from72 to 10948 yuan （ the median ： 1068 yuan）. The total frequency of tests and examinations ranged from 1 to 53 times （ the median ： 9. 0 times）. The number of items of tests and examinations ranged from 1 to 13 （the median ：6.0 items）. The frequency of repeated items ranged from 0 to 44 times （ the median： 3.0 times）. The number of repeated items ranged from 0 to 9 （ the median ： 2.0）. The frequent tests and examinations were blood routine test, ultrasound B, CT, urine routine test, X - ray, biochemical routine test, MRI, ECG and feces routine test. The tests and examinations frequency was positively correlated with the disorder course , the number of consulted departments and the total scores of HAMD （ P 〈 0.05 ）. The expense was positively correlated with the tests and examination frequency （ P 〈 0. 01 ）. Conclusion：There are various and repeated accessory tests and examinations in patients with somatization disorder and undifferentiated somatoform disorder. More attention should be paid on it.