北京市某区266例社区严重精神障碍患者及疑似患者应急医疗处置情况分析

Analyze of emergency medical treatment of 266 patients with severe mental disorders and suspected patients in a district of Beijing

目的了解北京市某区社区严重精神障碍患者及疑似患者应急医疗处置情况,并分析其相关因素。方法收集北京市某区2017年-2018年266例有危险行为的精神障碍患者应急医疗处置的基本信息,包括疾病病种、处置缘由、处置措施、应急医疗处置信息来源等,并对应急医疗处置案例的相关因素进行分析。结果应急医疗处置发生时,在档患者208例(78.2%),非在档疑似患者58例(21.8%)。应急医疗处置后,有26例(44.8%)非在档疑似患者明确诊断,纳入社区管理;存在危害公共安全或他人安全风险的131例(49.2%);采取紧急住院治疗141例(53.0%);危险性评级1级122例(45.9%);不同性别的患者危险性评级差异有统计学意义(χ2=7.837,P<0.05),3~5级危险性评级中男性占比更多;病情复发、精神状况恶化117例(44.0%);由患者家属提出应急医疗处置需求的最多,为138例(51.9%)。结论男性、青壮年、精神分裂症患者及疑似患者是应急医疗处置的主要相关因素。处置缘由以存在危害公共安全或他人安全的风险为主。

Objective To analyze the emergency medical treatment of confirmed or suspected severe mental disorder patients in a community in Beijing,and to discuss the related factors.Methods The basic records of emergency medical treatment of 266 patients with severe mental disorders and dangerous behaviors in a district of Beijing from 2017 to 2018 were collected,including disease types,treatment causes,treatment measures and information sources of emergency medical treatment,then the relevant factors analysis was carried out.Results At the time of emergency medical treatment,community management records showed that 208 patients(78.2%)were on file and 58 suspected patients(21.8%)were not.After emergency medical treatment,26 non-on-file patients(44.8%)were diagnosed and included in community management,131 cases(49.2%)posed a risk to public safety or that of others,and 141 cases(53.0%)were immediately hospitalized.Risk assessment classified 122 patients(45.9%)into grade 1.The risk rating had significant difference between male and female patients(χ2=7.837,P<0.05),and the proportion of cases at risk of grade 3~5 was more in males than that of females.Relapse and deterioration occurred in 117 patients(44.0%).138 patients(51.9%)were submitted by their family members.Conclusion Male,young adults,schizophrenic patients and suspected patients are the main relevant factors for emergency medical treatment,and endangering public safety or others'safety is the main treatment cause in emergency response.