综合医院精神科联络会诊特点分析  

Analysis on the characteristics of psychiatric liaison consultation in general hospital

作　　者：李硕 李育玲 徐勇 孟艳君 刘晓梅 王斌全 Li Shuo;Li Yuling;Xu Yong(Shanxi Medical University,Taiyuan 03000)

机构地区：[1]山西医科大学,山西太原030000 [2]山西医科大学第一医院 [3]山西中医药大学

出　　处：《中国现代医药杂志》2018年第11期5-8,共4页Modern Medicine Journal of China

摘　　要：目的了解综合医院精神科联络会诊现状及特点。方法收集山西医科大学第一医院近1年精神科联络会诊的所有住院患者病历,对患者一般人口学资料(年龄、性别)、来源科室、会诊次数、会诊原因、会诊诊断与治疗、住院时间、住院费用等情况进行统计学分析。结果近1年89.19%的非精神科室申请精神科会诊,会诊患者以内科为主,占全院精神科会诊总数的64.08%,尤其以心血管内科(17.63%)、神经内科(10.16%)、老年病科(8.22%)、呼吸科(6.50%)、消化内科(6.35%)、内分泌科(5.87%)患者居多;总会诊率为2.29%,会诊率前5位科室分别为重症医学科(11.73%)、国际医疗部(7.55%)、骨科(6.91%)、疼痛科(5.47%)、内分泌科(5.32%);常见会诊原因有睡眠问题、焦虑症状、抑郁症状和不能解释的躯体症状,比例高达78.42%(1050/1339);最常见的精神障碍为睡眠障碍(27.93%),其次为焦虑障碍(25.77%)、抑郁障碍(17.77%)、躯体形式障碍(14.56%);申请精神科会诊患者的平均住院日为16.15d,平均住院费用为25 498.36元,均高于申请除精神科以外会诊患者(14.06d、20 782.23元)、未申请会诊患者(8.71d、11 559.44元)。结论精神科会诊率与实际精神障碍患病率相比偏低,患者平均住院日相对延长,综合医院有待于进一步提高非精神科医生对患者心理问题的识别和处理能力,做到早识别、早诊断、早处理,改善疾病预后,提高患者生活质量,节约医疗资源。Objective To understand the current status and characteristics of psychiatric liaison consultation in a general hospital. Methods All hospitalized patients with psychiatric liaison consultation in the First Hospital of Shanxi Medical University were collected. Analyzed statisticsally the general demographic data （age, gender）,department, consultations time, consultation reason, consultation diagnosis and treatment, hospitalization time, hospitalization expense, etc. Results In the past one year, 89.19% of non-psychiatric departments applied for psychiatric consultation. The number of consultations was mainly internal medicine, accounting for 64.08% of the total number of psychiatric consultations in the hospital, especially in cardiology （17.63%）, neurology （10.16%）, geriatrics （8.22%）, respiratory department （6.50%）, gastroenterology （6.35%） and endocrinology （5.87%）. The total consultation rate was 2.29%, and the top 5 department was critical care medicine （11.73%）, international medical （7.55%）, orthopedics （6.91%）, pain （5.47%）, endocrinology （5.32%）. The common causes were sleep, anxiety, depressive symptoms and unexplained somatic symptoms, the proportion was 78.42%. The most common mental disorder was sleep disorder （27.93%）, followed by anxiety disorder （25.77%）, depression disorder （17.77%）, somatoform disorder （14.56%）. The average hospital stay for patients applying for psychiatric consultation was 16.15 days,and the average hospitalization cost was 25 498.36 yuan, which was higher than the patients applied for other consultation （14.06 days, 20 782.23 yuan） and those who did not apply for consultation （8.71 days, 11 559.44 yuan）. Conclusion The psychiatric consultation rate is lower than the actual prevalence of mental disorders, and the average hospitalization period of patients is relatively prolonged. The general hospital needs to further improve the ability of non-psychiatric doctors to identify and deal with patients＇ psyc

关 键 词：综合医院 精神科 联络会诊 会诊-联络精神病学 

分 类 号：R197.32[医药卫生—卫生事业管理]