慢性精神分裂症患者间断住院的康复效益分析

目的探讨间断住院结合家庭治疗对慢性精神分裂症的康复效益。方法将100 例慢性精神分裂症患者随机分入研究组和对照组，每组50 例。两组均使用非典型抗精神病药，研究组采取间断住院结合家庭治疗模式，对照组采取连续住院模式，观察治疗1 年。用阳性和阴性症状量表(PANSS)、日常生活活动能力(ADL)量表和精神分裂症患者生活质量量表(SQLS)，分别评定患者干预前后病情、ADL 和生活质量的变化，并进行成本效益分析。结果两组的干预对PANSS、ADL 和SQLS 评分有显著影响，两组入组后1 年末各项评分均较入组时显著下降(F 组内= 540.577, 318.148, 326.751，均P=0.000)；干预与时间存在交互效应(F 交互效应=13.710, 10.918, 6.578, P=0.000, 0.001, 0.012)；研究组各项评分减分值均大于对照组(t 差值=3.703, 3.304, 2.565, P=0.000, 0.001, 0.012)；研究组效益成本比值显著大于对照组(t=7.035, P=0.000)。结论间断住院结合家庭治疗较连续住院更有利于患者病情控制、日常生活能力和生活质量的改善和保持，康复效益更好。

Cost-effectiveness Analysis of Rehabilitation of Intermittent Hospitalization on Chronic Schizophrenia

Objective To analyze the cost-effectiveness of the rehabilitation of intermittent hospitalization combined with home treatment on chronic schizophrenics.Methods 100 patients with chronic schizophrenia were randomly assigned to study group and control group,50 cases in each group.All patients in both groups were treated with atypical antipsychotic drugs.An intermittent hospitalization combined with home treatment was given to the study group and a continuous hospitalization to the control group for a year.Positive and Negative Syndrome Scale(PANSS),Activities of Daily Living Scale(ADL) and Schizophrenia Quality of Life Scale(SQLS) were used to evaluate the patient’s condition and activity of daily living and quality of life before and after the intervention.In the meantime,a cost-effectiveness analysis was made.Results The interventions had significant influence on the scores of PANSS,ADL and SQLS in both groups.The scores of PANSS,ADL and SQLS were significantly lower 1 year after the intervention than before in both groups(FB= 540.577,318.148,326.751,all P=0.000).There was a significant interaction effect between intervention method and time in both groups on the scores of PANSS,ADL and SQLS(FAB=13.710,10.918,6.578,P=0.000,0.001,0.012).The decrease value of those scores was significantly greater in the study group than in the control group(t=3.703,3.304,2.565,P=0.000,0.001,0.012).The ratio of cost-effectiveness was larger in the study group than in the control group(t=7.035,P=0.000).Conclusion Intermittent hospitalization combined with home treatment is more beneficial for the patients with chronic schizophrenia in controlling the syndrome,keeping or improving the activity of daily living and the quality of life.Therefore its rehabilitation benefit is better than that of continuous hospitalization.