1例经多学科诊疗的复发精神分裂症病例  

A case of relapsed schizophrenia with multidisciplinary diagnosis and treatment

作　　者：俞天悦 胡瑶[1,2] 郭茜 胡昊 刘晓华 鹿凯利[3] 李冠军 YU Tian-yue;Hu Yao;Guo Qian;Hu Hao;Liu Xiao-hua;Lu Kai-li;Li Guan-jun(Shanghai Mental Health Center,Shanghai 200032,China)

机构地区：[1]上海市精神卫生中心,200030 [2]国家精神疾病医学中心、精神科急重症诊疗中心 [3]上海市交通大学医学院附属第六人民医院

出　　处：《临床精神医学杂志》2025年第1期63-65,共3页Journal of Clinical Psychiatry

基　　金：上海市精神心理疾病临床医学研究中心(19MC1911100);上海市公共卫生体系建设三年行动计划(2020-2022年)(GWV-10.2-YQ44)。

摘　　要：精神分裂症影响着全球约1%的人口,其发病和转归受遗传及社会心理多重因素共同影响。部分患者症状难以控制,疾病负担严重。本案例为1例复发的精神分裂症患者,首发治疗后数年小剂量药物维持治疗病情稳定,产后病情复发,调整多种药物合并氯氮平疗效欠佳,伴经前期急性激越、产后高凝肺栓塞可能、染色体异位及脑影像改变等多项异常情况。经多学科诊疗后,开展包括家庭环境调适、心理支持及探索性左乙拉西坦和屈螺酮炔雌醇片等综合干预,在延续先前精神科用药基础上患者病情缓解。Schizophrenia affects 1%of the world's population,and its onset and regression are influenced by the combination of genetic and psychosocial factors.Symptoms are difficult to control in some patients with severe burden.This case is a relapsed schizophrenia patient,who used to be stabilized several years with low-dose-medication maintenance therapy after the initial treatment,and then relapsed after giving a birth,with poor improvement of multiple medications,combined with a number of abnormalities such as poor efficacy of clozapine,premenstrual acute agitation,postnatal hypercoagulation,the possibility of pulmonary embolism,chromosomal ectopia,and brain imaging alterations.After multidisciplinary treatment,comprehensive interventions were carried out,including home environment modification,psychological support and exploratory using of levetiracetam and drospirenone ethinyl estradiol tablets with previous psychiatric medication.The patient's condition resolved.

关 键 词：精神分裂症 氯氮平 左乙拉西坦 多学科诊疗 

分 类 号：R749.3[医药卫生—神经病学与精神病学]