精神心理科开放病房与封闭病房住院患者临床用药特点分析  

Inventory survey of the clinical medication characteristics of open wards and locked wards in the psychiatric department

作　　者：文炳龙 安邦 李相利 马现仓[1] 高成阁[1] 王崴[1] WEN Binglong;AN Bang;LI Xiangli;MA Xiancang;GAO Chengge;WANG Wei(Department of Psychiatry, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061;Department of Psychiatry,Xianyang Central Hospital, Xianyang 712000, China)

机构地区：[1]西安交通大学第一附属医院精神心理卫生科,陕西西安710061 [2]咸阳市中心医院精神科,陕西咸阳712000

出　　处：《西安交通大学学报（医学版）》2020年第3期415-419,共5页Journal of Xi’an Jiaotong University（Medical Sciences）

基　　金：国家自然科学基金资助项目(No.81771471)。

摘　　要：目的分析比较精神心理科开放病房与封闭病房住院患者常用精神科药物使用特点。方法采用病例资料回顾性研究,收集2016年1月至10月在西安交通大学第一附属医院精神心理科(开放病房)与咸阳市中心医院精神心理科(封闭病房)住院的患者,其中开放病房1131人,封闭病房556人。对住院患者的合并用药情况、抗精神病药处方情况、抗抑郁药处方情况、情感稳定剂处方情况等资料进行归类描述和统计学分析。结果与封闭病房相比,开放病房住院患者单一用药的比例更高(P<0.01)。在合并用药对比中,以抗精神病药合并抗抑郁药组合比例更高(P<0.01),较少出现两种情感稳定剂合并使用的情况。使用频率最高的前2种抗精神病药为奥氮平和利培酮(P<0.01)。开放病房使用频率前3位的抗抑郁药物分别为文拉法辛、舍曲林、度洛西汀;封闭病房使用频率前3位的分别为帕罗西汀、舍曲林、文拉法辛。开放病房丙戊酸钠使用频率明显少于封闭病房(P<0.01)。结论精神科住院患者以非典型抗精神病药为主,符合单一用药的原则。双通道抗抑郁药在临床应用中逐渐增多,但SSRIs类仍为临床最常用的抗抑郁药。Objective To compare the clinical medication characteristics of hospitalized patients in the open and locked psychiatric wards.Methods A total of 1131 patients in open wards were selected from the Psychiatric Department,The First Affiliated Hospital of Xi'an Jiaotong University,and 556 patients in locked wards were selected from the Psychiatric Department of Xianyang Central Hospital from January to October 2016.We analyzed the combined medication,prescription status of antipsychotics,antidepressant and mood stabilizer.Results The rate of single drug use in the open wards was higher than that in the closed wards(P<0.01).Antipsychotics with antidepressants was the highest in the combined drugs(P<0.01)and less common combination of the two mood stabilizers.The first two most frequently used antipsychotics were olanzapine and risperidone(P<0.01).Venlafaxine,sertraline and duloxetine were the most frequently used antidepressants in open wards.Paroxetine,sertraline and venlafaxine were the top three antidepressants used frequently in closed wards.The frequency of sodium valproate use in open wards was significantly lower than that in closed wards(P<0.01).Conclusion Atypical antipsychotics are the main medication for psychiatric inpatients,and are consistent with the principle of single medication.Dual-channel antidepressants are gradually increasing in clinical applications,but SSRIs are still the most commonly used antidepressants in clinical practice.

关 键 词：开放病房 封闭病房 精神疾病 临床用药 

分 类 号：R749.05[医药卫生—神经病学与精神病学]