基层综合医院自杀未遂患者精神科会诊的调查分析  

Investigation and analysis on psychiatric consultation in patients with suicide attempt in primary general hospitals

作　　者：翁小娟 陈礼贤 吴福斌 周朝昀 叶建华 方春养 WENG Xiaojuan;CHEN Lixian;WU Fubin;ZHOU Chaoyun;YE Jianhua;FANG Chunyang(Department of Psychiatry,the First People's Hospital of Wenling City in Zhejiang Province,Wenling 317500,China;Department of Psychiatry,the Second People's Hospital of Yuhuan Cityin Zhejiang Province,Yuhuan 317605,China;Department of General Practice Medicine,the First People's Hospital of Wenling City in Zhejiang Province,Wenling 317500,China;Medical Record Room,the First People's Hospital of Wenling City in Zhejiang Province,Wenling 317500,China;Department of Quality Control,the First People's Hospital of Wenling City in Zhejiang Province,Wenling 317500,China)

机构地区：[1]浙江省温岭市第一人民医院精神科,浙江温岭317500 [2]浙江省玉环市第二人民医院精神科,浙江玉环317605 [3]浙江省温岭市第一人民医院全科医学,浙江温岭317500 [4]浙江省温岭市第一人民医院病案室,浙江温岭317500 [5]浙江省温岭市第一人民医院质控科,浙江温岭317500

出　　处：《中国现代医生》2020年第15期166-169,共4页China Modern Doctor

基　　金：江苏省青年医学重点人才项目(QNRC2016315);浙江省温岭市科技计划项目(2019S0180061)。

摘　　要：目的了解综合医院自杀未遂患者的精神科会诊状况。方法以2017年1月1日~2019年8月31日期间温岭和玉环两家综合性医院收治的以过量服药或服农药自杀未遂住院患者为研究对象,试图了解自毒自杀未遂患者精神科会诊情况及影响因素。结果本次调查共280例自毒患者纳入研究,男148例,女132例,自毒人群集中于中老年人群,平均年龄(49.3±20.5)岁,只有40%患者报告有精神心理疾病史,144例患者在入院时被接诊医生询问自毒原因,住院期间请精神科会诊的有45例,占16.1%;出院时提示院外精神科门诊随诊的有62例;所有患者出院后1个月内到精神科随诊的有45例,占总调查人群的16.1%。相比较而言,有既往相关病史或入院时被询问自毒原因更可能得到精神科会诊,且差异有显著性(P<0.05);有既往相关病史或住院期间精神科会诊或出院被提示精神科随诊的患者更可能出院后到精神科就诊,且差异有显著性(P<0.05)。结论自毒患者的精神科会诊率、院外精神科随诊率较低,入院接诊医生对自毒患者的心理因素关注度可提高精神科会诊率,精神科会诊又与院外精神科随诊密切相关。Objective To understand the psychiatric consultation status of patients attempting suicide in general hospitals.Methods Patients who attempted suicide with drug overdosing or pesticide taking were admitted to two general hospitals in Wenling and Yuhuan City from January 1,2017 to August 31,2019.They were selected as the research subjects.The psychiatric consultation status and influencing factors of patients attempting suicide with poisons were attempted to understand.Results A total of 280 patients with self-poisoning were included in the survey,including 132 females and 148 males.The self-poisoning population was concentrated in the middle-aged and elderly population,with an average age of(49.3±20.5)years old.Only 40%of patients were reported to have histories of mental illness.144 patients were asked about the cause of self-poisoning by their attending doctors upon admission.During hospitalization,45 patients were given psychiatric consultation,accounting for 16.1%of the total;62 patients were informed of attending follow-up visits at the outpatient psychiatric clinic upon discharge;there were 45 patients who attended follow-up visits in the department of psychiatry within one month after discharge,accounting for 16.1%of the total survey population.In comparison,psychiatric consultation was more likely to be carried out for the patients with a history of related medical conditions or those who were asked about the cause for self-poisoning upon admission,and the differences were significant(P<0.05);patients with past medical history,those receiving psychiatric consultation during hospitalization,or those informed of attending follow-up visits at the psychiatric clinic upon discharge were more likely to attend visits at the department of psychiatry after discharge,and the differences were significant.Conclusion The rate of psychiatric consultation and out-of-hospital psychiatric follow-up rate in the patients with self-poisoning are relatively low.Admitting doctors'attention to the psychological factors of pati

关 键 词：综合性医院 自杀 联络会诊 再自杀干预 

分 类 号：R749[医药卫生—神经病学与精神病学]