抗精神病药致便秘187例临床研究  

Antipsychotic-induced constipation:clinical study of 187 cases

作　　者：肖逸丽[1] 柳勤斌[2] 高镇松[2] 邱鹏[2] 陈仪[2] 

机构地区：[1]汕头市第四人民医院药械设备科,广东515021 [2]汕头市第四人民医院

出　　处：《社区医学杂志》2013年第21期3-5,共3页Journal Of Community Medicine

摘　　要：目的分析抗精神病药致便秘的原因,探讨对策,以期对住院精神病患者服用抗精神病药出现便秘的临床治疗提供参考。方法选择2012年7—12月住院服用抗精神病药的精神病患者187例,通过查阅患者病历资料,统计符合条件患者服用的抗精神病药种类、有无合用苯海索、药物剂量和每天大便次数,比较服用不同抗精神病药、是否合用苯海索及不同用药剂量患者便秘发生率。计数资料采用χ2检验,P<0.05为差异有统计学意义。结果 187例患者中发生便秘83例,占44.39%。便秘发生率氯氮平单用为43.33%,氯氮平+氯丙嗪为69.44%,氯氮平+其他为52.54%,吩噻嗪类为26.09%,其他(利培酮、奎硫平等)为20.51%,氯氮平单用或联用的前3种组合便秘发生率高于吩噻嗪类和其他药物,比较差异有统计学意义(χ2=17.86,P<0.05)。前3种组合中氯氮平+氯丙嗪的便秘发生率最高,与其他两组比较差异有统计学意义(χ2=4.15,P<0.05)。抗精神病药合用苯海索74例,便秘发生率为59.46%;未合用苯海索113例,便秘发生率为34.51%,比较差异有统计学意义(χ2=11.27,P<0.05)。用药剂量≥300 mg/d 134例,便秘发生率为50.75%;<300 mg/d 53例,便秘发生率为28.30%,比较差异有统计学意义(χ2=7.75,P<0.05)。结论通过合理用药、护理干预和适当药物治疗等综合治疗措施可有效降低抗精神病药致便秘的发生率。Objective To analyze the causes and countermeasures of antipsychotic-induced constipation,so as to provide a refer- ence to clinical treatment for antipsychotic-induced constipation in hospitalized psychiatric patients.Methods From July to De- cember in 2012,187 hospitalized psychiatric patients treated with antipsychotics were selected.With a review of inpatient medicalrecords,statistics were made in included patients for categories of antipsychotics they used,the use of benzhexol,drug dose and daily frequency of bowel movement.Compare taking different antipsychotics,the suitability of the different drug doses trihexyphenidyl and the incidence of patients with constipation.22 test was used for count data, the result of P〈0.05 was considered statistically significant. Results Constipation occurred in 83 cases,accounting for 44.39%.The incidence of constipation clozapine alone was 43.33%, 69.44%,clozapine＋chlorpromazine,clozapine＋others was 52.54%,phenothiazines was 26.09%,other （risperidone,quetiapine,etc） was 20.51%,clozapine alone or in combination with the first three combinations of constipation was higher than phenothiazines and other drugs,the difference was statistically significant^-17.86,P〈O.O5）.Former three combinations of chlorine olanzapine ＋ chlorpro- mazine highest incidence of constipation,with the other two groups was statistically significant difference（x2=4.15,P〈0.05）.Seven- ty-four cases were treated with antipsychotics combined with benzhexol,the incidence of constipation was 59：46%;113 cases didn＇t take additional benzhexol, the incidence of constipation was 34.51%,and the difference was statistically significant（x2=1 1.27, P〈O.OS）.For 134 cases receiving antipsychotics with a dose ≥300 mg/d,the incidence of constipation was 50.75%;for 53 cases receiving antipsychotics with a dose〈300 mg/d,the incidence of constipation 28.30%,the difference was statistically significant （x2=7.75,P〈0.05）.Conclusion Comprehensive treatment measures such as rational medi

关 键 词：抗精神病药 便秘 氯氮平 苯海索 

分 类 号：R971[医药卫生—药品]