综合医院门诊失眠患者临床特征的回顾性分析  

Retrospective analysis of outpatients with insomnia in general hospital

作　　者：徐倩[1] 徐斌[1] 郑炜华[1] XU Qian;XU bin;ZHENG Wei-hua(Ruijin Hospital,Shanghai JiaoTong University School of Medicine,Shanghai 201801,China)

机构地区：[1]上海交通大学医学院附属瑞金医院,201801

出　　处：《临床精神医学杂志》2021年第4期316-319,共4页Journal of Clinical Psychiatry

摘　　要：目的:探讨综合医院门诊失眠症患者的就诊特征及用药特点。方法:回顾性分析2015至2017年我院失眠诊疗情况,将就诊科室、疾病诊断、患者信息和药物用法用量等数据进行统计分析,明确失眠症患者的诊疗特征和用药情况等。结果:2015~2017年间,我院门诊失眠诊疗患者逐年增加,就诊总数为17329例次,主要集中在31~70岁,合计13050例次,占75.31%,其中女性为10661例次(61.52%)、男性为6668例次(38.48%);63.55%的患者就诊于神经内科、其次分别为中医科17.15%,心血管科8.59%;在诊断失眠合并其他疾病的患者中,合并高血压的就诊例次占41.61%,其次占比>9%的分别为冠状动脉粥样硬化性心脏病、头晕和眩晕,慢性胃炎,头痛等疾病。门诊失眠患者中>84%均采取了药物干预,选择药物多为非苯二氮艹卓类镇静催眠药和中成药,但呼吸科就诊患者的药物治疗比例仅为12.88%。镇静催眠类药物使用控制在一周内的比例为94.28%,超过8周的比例不超过5%。结论:失眠例次随着年龄的增长而逐步上升,在50~60岁期间达到最高值后逐步下降,40~70岁范围内女性患者例次与男性患者例次比例差异尤其显著。综合医院门诊失眠患者主要就诊于神经内科、但合并其他疾病时患者会倾向于先到中医科、心血管科等其他科室就诊,首选药物治疗。Objective:To explore the current situation of insomnia diagnosis and treatment in general hospital.Method:the data of insomnia diagnosis and treatment in our hospital from 2015 to 2017 were collected,and the department,disease diagnosis,patient information,drug usage and dosage were analyzed retrospectively.Results:From 2015 to 2017,the number of outpatients with insomnia in our hospital increased year by year,with a total of 17329 visits,mainly concentrated in 31-70 years old,with a total of 13050 visits,accounting for 75.31%,including 10661 female visits,accounting for 61.52%,and 6668 male visits,accounting for 38.48%;63.55%of the patients visited neurology department,followed by traditional Chinese medicine(TCM)department,accounting for 17.15%,cardiovascular department 8.59%;In the diagnosis of insomnia patients with other diseases,the number of patients with hypertension accounted for 41.61%,followed by coronary atherosclerotic heart disease,dizziness and vertigo,chronic gastritis,headache and other diseases accounted for more than 9%.More than 84%of outpatients with insomnia took drug intervention,most of them chose non benzodiazepines and Chinese patent medicine,but only 12.88%of patients in respiratory department took drug treatment.The proportion of sedative and hypnotic drugs controlled within one week was 94.28%,and the proportion over eight weeks was less than 5%.Conclusion:The number of insomnia increased with the age,and decreased gradually after reaching the highest value between 50-60 years old,and the proportion of female patients and male patients in the range of 40-70 years was especially significant.Insomnia patients in general hospital mainly visit neurology department,but when other diseases are combined,patients tend to go to other departments of TCM and cardiovascular department first.Drug treatment is preferred.

关 键 词：失眠 诊断 回顾性分析 

分 类 号：R749.3[医药卫生—神经病学与精神病学]