我院840例住院儿童青少年精神疾病患者用药医嘱分析

Analysis of Medical Orders for 840 Child and Adolescent Psychiatric Inpatients in Our Center

目的:调查我院住院儿童青少年精神疾病患者疾病分类及用药情况。方法:采用分层随机抽样方法抽取我院2011-2013年840例住院儿童青少年精神疾病患者用药医嘱,对患者年龄、性别、疾病诊断、用药情况进行统计、分析。结果:住院儿童青少年精神疾病患者发病率排前3位的分别是精神分裂症及分裂型障碍(55.1%)、心境障碍(9.9%)和起病于童年与少年期的行为与情绪障碍(5.1%);不能确诊的疾病分类的状态诊断约占病例数的20%。治疗精神疾病及相关药物医嘱数最多(约占68%),其中抗精神病药占到35.30%;其他药品占总用药医嘱数的约30.96%。用药例次最高的也是抗精神病药,为1 570例次;使用频次最高的是抗抑郁药(5),表明住院儿童青少年精神疾病患者使用抗抑郁药的平均次数高于其他药物。结论:目前用于治疗精神疾病的药品说明书,多数缺少儿童青少年适应证的使用信息。临床医师需评估疗效与风险后,谨慎使用治疗药物。

OBJECTIVE： To investigate the classification of diseases and drug use of child and adolescent psychiatric patients in our center. METHODS： Medical orders for 840 child and adolescent psychiatric inpatients were selected from our hospital using stratified random sampling method during 2011- 2013. Those medical orders were analyzed statistically in respects of age, gen- der, diagnosis, the number of medical orders, medication method, the percentage of case number and frequency of drug use. RE- SULTS： The incidence of child and adolescent psychiatric inpatients in the top three were schizophrenia, schizotypal disorder （55.1%）, mood disorders （9.9%） and the onset of behavioral and emotional disorders in childhood and adolescence （5.1%）. About 20% state diagnosis cannot be confirmed. The number of medical orders for mental illness and related medicines were the highest （about 68% ）, in which antipsychotic drugs accounted for 35.30% and other drugs accounted for 30.96%. The case num- ber of antipsychotic drugs use was the highest （1 570 cases）. The frequency of antidepressant drugs use was the highest （5）, which indicated the average case number of antidepressant drugs use was higher than that of other drugs in child and adolescent psychiatric inpatients. CONCLUSIONS： Most of package inserts of drugs for psychiatric disease lack of the information about child and adolescent indication. Clinical physicians should use drugs for psychiatric disease carefully after evaluating therapeutic efficacy and risk.