精神科急诊670例紧急抢救患者临床特点分析

Analysis of clinical characteristics of 670 emergency rescue cases in ten years in psychiatric departments

目的:了解精神科急诊留院抢救患者的临床情况。方法:应用自编调查表对2001年1月至2011年2月北京安定医院急诊因急重症就诊留院抢救治疗的670例患者,就性别、年龄、病种、意识状态、抢救天数、转归、有无季节性的特点进行总结,并对急性药物中毒患者过量服用药物的种类、数量及对患者预后的影响进行归纳及分析。结果:精神科急诊重症抢救患者以急性药物中毒为主,其次为酒精戒断综合征和严重躯体疾病伴发精神障碍;54.03%的患者存在意识问题,25.97%的患者存在昏迷及谵妄;绝大多数患者经抢救可好转离院,但也有12.39%患者因病情加重需要转院甚至死亡;随着新型药物使用的增多,药物中毒及其重症病例的发生减少。结论:应该重视精神科急诊医生的综合培训,使用新型药物可减少药物过量的发生风险及其不良预后。

Objective：To explore the clinical status of emergency rescue patients in psychiatric depart- ments. Method： With self-designed questionnaire, to generalize and analyze the information of 670 patients, who were hospitalized for rescue in Beijing Anding Hospital due to acute or serious cases during the period from January 2001 to Fehruary 2011 ,in terms of their characteristics in sex, age,kind of disease, status of conscious- ness, rescue days, clinical outcome, and seasonality; in respect of acute overdosage cases, to summarize and ana- lyze the kind of medicine,quantity,and influence on prognosis. Results：Overdosage constitutes the most sig- nificant cause of emergency rescue cases in psychiatric departments, while alcohol withdrawal syndrome and se- rious physical disease accompanied by mental disorders are the secondary causes. 54.03% of the patients have consciousness disorder, and 25.97% of the patients suffer from coma or delirium. Most of the patients recovered and were released from hospital after rescue,while 12.39% of the patients grew worse and needed to be trans- ferred to other hospitals or died. With the increase of application of new type medicine, overdosage and related serious cases decreased. Conclusion： Comprehensive training of emergency doctors in psychiatric depart- ments should be strengthened;application of new type medicine may reduce the risks of overdosage and unwant- ed prognosis.