【摘要】：目的:1.了解綜合性醫(yī)院精心理衛(wèi)生科會診患者的臨床特點，以更好地指導(dǎo)心理科醫(yī)生的會診工作。 2.明確不同科室聯(lián)絡(luò)會診病人的特點,有目的的有針對性的對不同科室臨床醫(yī)生進(jìn)行相關(guān)培訓(xùn)，以提高臨床醫(yī)生對精神科相關(guān)疾病的識別及處理能力。 3.探索一種新的聯(lián)絡(luò)會診精神病學(xué)的發(fā)展模式。 方法:匯總2000年4月～2011年9月我院精神科聯(lián)絡(luò)會診病歷，資料完整者共1417例,采用SPSS16.0統(tǒng)計分析一般人口資料、各科會診人數(shù)及病種構(gòu)成、會診原因、診斷、處理、隨訪次數(shù)構(gòu)成，并與心理衛(wèi)生門診病種對比。 結(jié)果：1417例會診病例中年齡段以36-50歲和51-70歲為主，占59.5%，與國內(nèi)外報道結(jié)果一致。性別男:女為0.782:1。教育程度以小學(xué)初中為主,占52.9%。會診較多的科室依次為神經(jīng)內(nèi)科、心內(nèi)科、急診科和消化內(nèi)科，與國內(nèi)相關(guān)文獻(xiàn)對比有差異。會診病例中無精神科診斷者92例，占6.5%；有精神科診斷的1325例,占93.5%，其中病種以神經(jīng)癥(包括焦慮障礙、強迫癥、恐怖癥等)、抑郁障礙、器質(zhì)性精神障礙列前3位。處理：建議藥物治療1254例，占88.5%；建議醫(yī)學(xué)檢查或其他科室會診59例，占4.2%；轉(zhuǎn)精神�？漆t(yī)院住院治療11例,占0.8%；建議心理咨詢10例,占0.7%。追蹤1254例藥物治療的患者，遵醫(yī)囑服藥者1244例，其中隨診1次者427例,隨診2次者257例,隨診3-5次者249例，隨訪5-10次者214例，長期隨訪者(㧐10次)97例；其中療效好轉(zhuǎn)623例,顯效434例，痊愈130例，無效57例。比較綜合醫(yī)院心身科門診病例的病種分布，前三位為：神經(jīng)癥、抑郁障礙、器質(zhì)性精神障礙，而門診就診隨訪次數(shù)最多的病種前三位是：抑郁障礙、神經(jīng)癥、精神分裂癥。 結(jié)論:①綜合醫(yī)院臨床各科住院病人均存在心理、精神疾病及心身障礙，各科室會診病種有差異，應(yīng)加強精神科聯(lián)絡(luò)會診工作,以提高臨床科室病人的痊愈率和住院滿意度。②綜合醫(yī)院心身科門診最常見病種依次為抑郁癥，焦慮癥，神經(jīng)癥。CLP會診最常見病種依次為焦慮癥、抑郁癥，器質(zhì)性精神病。③應(yīng)該盡快改變精神病院與綜合醫(yī)院的分裂割據(jù)局面,同時應(yīng)加強綜合醫(yī)院各科室輪轉(zhuǎn)醫(yī)生的培訓(xùn)，，進(jìn)一步提高各科醫(yī)生對精神疾病的識別和處理能力。
[Abstract]:Purpose 1. To understand the clinical characteristics of the consultation patients in the department of fine mental health in general hospital, and to guide the consultation work of the psychiatrist better. 2. In order to improve the ability of the clinicians to recognize and deal with the psychiatric diseases, the characteristics of the patients in different departments were determined, and the relevant training for the clinicians in different departments was carried out with the aim of improving the ability of the clinicians to recognize and deal with the psychiatric diseases. 3. To explore a new approach to the development of psychiatry. Methods: from April 2000 to September 2011, a total of 1417 cases with complete data were collected. The general population data, the number of consultations, the types of diseases, the causes of consultation, diagnosis and treatment were analyzed by SPSS16.0. The frequency of follow-up was compared with that of mental health outpatient. Results among 1417 consultation cases, 36-50 years old and 51-70 years old were the main age groups, accounting for 59.5%, which was consistent with the results reported at home and abroad. Sex: male: female: 0.782: 1. The education level is mainly primary school junior middle school, accounting for 52.9%. The departments of consultation were neurology, cardiology, emergency department and digestive department, which were different from domestic literatures. There were 92 cases (6.5%) without psychiatric diagnosis and 1325 cases (93.5m) with psychiatric diagnosis. Among them, neurosis (including anxiety disorder, obsessive-compulsive disorder, phobia, etc.), depressive disorder and organic mental disorder ranked first 3. Management: 1254 cases (88.5%) were recommended to be treated with drugs; 59 cases (4.2%) were recommended to be consulted by medical examination or other departments; 11 cases (0.885%) were hospitalized in psychiatric hospital; 10 cases (0.775%) were recommended psychological counseling. Of the 1254 patients who were followed up by drug therapy, 1244 were treated with medicine according to the doctor's advice, including 427 patients who were followed up once, 257 patients were followed up twice, 249 patients were followed up for 3-5 times, 214 patients were followed up for 5-10 times, 97 patients were followed up for a long period of time, among them, 623 patients had improved the curative effect. There were 434 cases with remarkable effect, 130 cases were cured and 57 cases were ineffective. The first three diseases were neurosis, depressive disorder, organic mental disorder, and the first three diseases were depressive disorder, neurosis and schizophrenia. Conclusion there are psychological, mental disorders and psychosomatic disorders in all the clinical departments of the General Hospital, and there are differences in the types of consultation in different departments, so it is necessary to strengthen the work of liaison and consultation in psychiatric departments. In order to improve the recovery rate and hospital satisfaction of patients in clinical departments, the most common diseases in psychosomatic outpatient department in general hospital were depression, anxiety disorder, neurosis, CLP consultation, anxiety disorder and depression, respectively. At the same time, we should strengthen the training of rotation doctors in general hospitals to further improve the ability of identifying and handling mental diseases.
【學(xué)位授予單位】：福建醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號】：R749

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