老年髋部骨折后反应性精神障碍的抗精神病治疗与临床分析

Clinical Treatment and Analysis of the Antipsychotic Therapy in the Reactive Mental Disorders after Hip Fractures

目的:探讨老年髋部骨折后反应性精神障碍患者抗精神病治疗的有效性及用药的安全性。方法:选取笔者所在科2012年11月-2014年11月收治的109例老年髋部骨折后反应性精神障碍患者,根据患者及家属治疗意愿分为对照组及试验组,对照组23例患者采用一般性综合支持治疗,试验组86例在一般性综合治疗的基础上予以抗精神病治疗,分析两组患者精神障碍好转时间、住院时间、并发症发生率及死亡率的差异。结果:对照组精神障碍平均好转时间为(4.5±2.7)d,治疗1周后治愈2例,2周后治愈19例,死亡2例。试验组患者精神症平均好转时间为(2.3±1.2)d,治疗1周后治愈63例,2周后治愈21例,死亡2例。与对照组比较,试验组无明显药物毒副作用产生,住院时间明显缩短,并发肺部感染、心脑血管意外、胃肠功能紊乱等并发症概率减少,两组比较差异均有统计学意义(P<0.05)。结论:反应性精神障碍在老年髋部骨折患者中较为常见,在临床工作中应提高重视及尽早使用精神类药物,减少相关并发症的发生。

Objective：To investigate the clinical effectiveness and safety of the antipsychotic treatment of the reactive mental disorders in the elderly people after hip fractures.Method：109 senile hip fracture patients with delirium were selected from November 2012 to November 2014 in our department,which were divided into the control group and the experimental group,according to the patients and their families willingness.23 cases in the control group,which were treated with general supportive therapy,86 cases in the experimental group,which were treated with antipsychotic therapy on the basis of general supportive treatment.The statistical analysis was done between the two groups of patients in the improvement time of schizophrenia,hospitalization time,complications and mortality.Result：The average improvement time in the control group was（4.5±2.7） days after treatment,2 patients were cured after 1 week of treatment among them,19 patients were cured after 2 weeks＇ treatment,2 cases dead.The average improvement time in the experimental group was（2.3±1.2） days after treatment.63 patients were cured after 1 week of treatment,21 patients were cured after 2 weeks＇ treatment,2 cases dead.Compared with patients in the control group,the experimental group had no significant side effects of drugs,the hospital stay was significantly shorter,and less risk to complications such as pulmonary infection,cardiovascular and cerebrovascular accident,gastrointestinal dysfunction and so on,the statistics differences between twe groups were significant（P〈0.05）.Conclusion：Delirium is very common among the elderly individuals with hip fractures,we should pay more attention to it in our clinical work,and the using of psychotropic drugs should be adopted as early as possible to reduce the occurrence of the related complications.