定期电话随访对精神分裂症复发的预防作用

Preventive Effect of Regular Follow-up by Telephone on Relapse of Schizophrenia

目的探讨定期电话随访对精神分裂症复发的干预效果。方法将200例精神分裂症患者随机分入随访组和对照组,每组100例,住院期间按诊疗常规治疗护理,给予非典型抗精神病药治疗,临床痊愈出院后,对照组门诊随诊,随访组电话随访干预,时间2年。结果两组的干预对PANSS评分有随时间变化的趋势(F组内=79.064,P=0.000),干预与时间存在交互效应(F交互=6.929,P=0.000)且组间差异有统计学意义(F组间=25.385,P=0.000);同期对照比较,在出院后第6、12、18、24月末,随访组增分幅度均小于对照组(t=6.243、3.975、2.756和4.144,P=0.000、0.000、0.006和0.000),各时点累计复发率和复发次数随访组均低于对照组(χ2=5.701、4.528、4.160和3.977,t=2.410、3.948、3.638和4.113,P=0.017、0.033、0.041、0.046、0.017、0.000、0.000和0.000)。结论定期电话随访干预有利于精神分裂症患者保持病情稳定,减少复发。

Objective To explore the intervention effect of regular follow- up by telephone on the relapse of schizophrenia. Methods Two hundred patients with schizophrenia were randornly assigned into the follow-up group and the control group （each n= 100）. During their hospitalization, all patients in the both groups were given conventional treatment and nursing and simultaneously treated with atypical antipsychotic drugs. After getting a clinical recovery and discharge, the patients in the follow- up group received a follow- up intervention by telephone for two years, while the patients in the control group received an outpatient service. Results There was a significant change trend by time about the intervention methods on scores of PANSS in the both groups （ FB = 79. 064, P = 0. 000）. There was a significant interaction effect between intervention method and time （ FAB = 6. 929, P = 0. 000）, moreover, there were statistically significant differences （ FA = 25. 385, P = 0. 000） between the both groups on the scores of PANSS. At the end of 6th, 12th, 18th and 24th months after discharge, the increase ranges of the scores in the follow - up group were all less than those in the control group （ t = 6. 243, t = 3. 975, t = 2. 756, t = 4. 144; P = 0. 000, P = 0. 000, P = 0. 006, P = 0. 000）. The accumulative total relapse rate and relapse frequency at each time point after discharge in the follow- up group were all lower than those in the control group （ X^2 = 5. 701, X2 = 4. 528, 2 _ 4.160, X^2=3.977; t=2.410, t=3.948, t=3.638, t=4.113; P=0.017, P=0.033, P=0.041, P=0.046, P= 0. 017, P = 0. 000, P = 0. 000, P = 0. 000）. Conclusions The regular follow - up intervention by telephone is beneficial to patients with schizophrenia in controlling the state of the illness and reducing the relapse frequency.