近十年住院精神病患者猝死病例分析

Case analysis of sudden death of psychiatric patients within recent ten years

目的:对住院精神病患者猝死原因进行了回顾性调查分析,寻找经验和规律。方法:采用自编调查表对患者的性别、年龄、病程、住院次数、精神疾病诊断、合并躯体疾病诊断、住院服药情况、死亡原因、死亡时间等进行逐一调查分析。结果:猝死患者在性别上没有明显差别,年龄多在45岁以上,病程上很多是20年以上,反复住院多次,长期服用抗精神病药,死亡前部分有心电图异常等情况,死亡时间半数在节假日的晚上或者是清晨。提示长期服药的中、老年患者;伴有躯体疾病,特别是心脏疾病的精神病患者容易出现猝死,特别是在节假日等工作人员稀少,疏于查房,忽略了必须重点关注的患者。结论:重点关注中、老年长期患病、长期服药的精神病患者,应经常进行心电图等辅助检查,密切观察病情变化,对伴有躯体疾病的精神病患者,在节假日期间要重点交班,特别关注。

Objective: To search for factors contributing to sudden death of hospitalized psychiatric patients through a retro-spective investigation and analysis on the medical cases. Methods:A progressive analysis was done on the following factors, such as sex, age, course of disease, number of hospitalization, diagnosis of mental illness, diagnosis of physical illness annexed, conditions of hospitalization and medication, direct causes to death, and time of death by using a self-drafted investigation form. Results:The pa-tients of sudden death showed no difference in sex. Mainly, they were aged above 45 years old, were suffered the psychosis for more than 20 years and frequently hospitalized, and chronically took anti-psychotic drugs. Part of them showed abnormal electrocardiograms prior to death. Half of them died in the evening or dawn of holidays or festivals. It should be prompted that the middle-aged or senior patients who chronically took medication, and patients with annexed physical diseases, especially heart diseases, were prone to suffer sudden death. Holidays and festivals were another significant factor, when few medical personnel were available. Also, during these holidays and festivals, they were easy to neglect caring of the patients and checking the patients who needed more attention. Conclu-sions:It's important to pay more attention to the middle-aged or senior patients who have suffered the mental illness and taken medica-tion for a long time. They need to be frequently checked by using assistant examination tools, such as electrocardiogram, and the change in patients' condition should be closely followed. For those psychiatric patients who have physical diseases annexed, they de-serve more concerns during change of shift in holidays or festivals, and more care should be taken to them.