精神障碍患者发生肺血栓栓塞症分析

Analysis of pulmonary thromboembolism in patients with mental disorders

目的:探讨精神障碍患者发生肺血栓栓塞症(PTE)情况。方法:回顾性分析35例发生PTE的住院精神障碍患者的一般及临床资料。结果:35例患者平均年龄(56.4±14.1)岁;临床诊断主要为未特定的非器质性精神病8例(22.9%),脑器质性精神障碍7例(20.0%),抑郁症6例(17.1%),双相障碍5例(14.2%),精神分裂症4例(11.4%)等。使用较多的抗精神病药为利培酮(42.9%)、奥氮平(31.4%)。22例(62.9%)患者存在躯体制动,7例使用镇静催眠药(20.0%)。31例患者发生PTE时无明显症状。所有患者血清D-二聚体水平增高,并经CT肺动脉造影(CTPA)确诊。结论:有躯体制动的住院精神障碍患者更易发生PTE,且无明显症状,血清D-二聚体水平增高及CTPA可确诊。

Objective:To investigate the incidence of pulmonary thromboembolism(PTE)in patients with mental disorders.Methods:The general and clinical data of 35 inpatients with PTE were retrospectively analyzed.Results:The mean age of 35 patients was(56.4±14.1).The main clinical diagnoses were non-specific psychosis(n=8,22.9%),brain organic mental disorder(n=7,20.0%),depression(n=6,17.1%),bipolar disorder(n=5,14.2%),schizophrenia(n=4,11.4%),etc.Risperidone(42.9%)and olanzapine(31.4%)were the most commonly used antipsychotics.22 patients(62.9%)had physical immobilization,and 7 patients(20.0%)were treated with sedative hypnotics.31 patients had no obvious symptoms when PTE was diagnosed.All patients had elevated serum D-dimer levels and were confirmed by CT pulmonary angiography(CTPA).Conclusion:PTE is more likely to occur in inpatients with mental disorders with somatic immobilization without obvious symptoms,which can be confirmed by increased serum D-dimer level and CTPA.