长期服用抗精神病药物患者肝脏B超检查结果分析

目的探讨长期服用抗精神病药物的精神分裂症患者的肝脏B超检查异常情况及相关性。方法对1255例服用抗精神病药物≥2a的精神分裂症患者进行肝脏B超检查,并对不同病程及服药时间、年龄段、性别、疾病类型的B超检查结果进行对比分析。结果肝脏B超检查阳性率28.1%,其中脂肪肝发生率(24.7%)占阳性率的88.1%;年老、病程及服药时间长的患者肝脏B超阳性率明显高于年轻、病程及服药时间较短的患者(P均<0.05);不同性别、不同疾病类型患者肝脏B超阳性率无显著性差异(P均>0.05)。结论长期服用抗精神病药物易出现药源性脏器损伤,尤以肝脏最为显著。应定期检查,及时防治。     

住院精神分裂症患者用药现状调查分析

目的 了解住院精神分裂症患者精神科药物的使用现状及出院坚持用药情况。方法 采取横断面调查宝鸡市绛帐精神病医院2004至2005年502例住院精神分裂症患者精神科药物使用情况及出院后复诊、回访，了解坚持治疗用药状况。结果 非典型抗精神病药占主要地位；经典抗精神病药物使用下降；很少联合用药。结论 为了临床用药的安全性和患者的依从性，精神科临床用药发生了很大的变化；药物的合理使用不断规范；科普知识的缺乏、过重的经济负担常导致治疗中断，是精神分裂症患者出院后病情复发的常见现象。     

住院精神分裂症患者腹部B超临床研究

目的 探讨住院精神分裂症患者腹部B超检查阳性率及其相关影响因素.方法对499例精神分裂症患者腹部B超检查的临床资料进行回顾性分析.结果 本组患者腹部B超检查阳性率为38.9%,其中肝胆异常占总阳性率的90.7%;B超检查阳性结果与患者年龄、体质量、服药时间、住院时间和Ⅰ型精神分裂症呈显著正相关(P＜0.05或0.01).结论住院精神分裂症患者腹部B超检查阳性率高,年龄大、肥胖、长期住院等是影响腹部B超检查阳性结果的独立危险因素.     

精神分裂症住院患者抗精神病药使用现状调查

目的探讨抗精神病药在精神分裂症住院患者中的使用现状．为临床合理用药提供帮助。方法对5年来在我院住院的474例精神分裂症、分裂样精神病患者应用抗精神病药物的临床资料进行回顾性分析。结果利培酮使用率由1998年的22．39％上升到2002年的81.08％,氯氮平由1998年的76．47％下降到2002年的29．73％,氯丙嗪、舒必利、奋乃静也有明显下降;单一用药由1998年的63．24％上升到2002年的72．07％;两种药物联用占25．53％,3种联用占3．16％;联合用药由1998年的36．76％下降至2002年的28．83％;2000年前氯氮平与舒必利联用最多,2000年后利培酮与氯氮平联用最多。结论新型抗精神病药物在临床替代传统药物的速度明显加快,且逐渐趋于单一化用药。     

126例住院女性精神分裂症患者治疗用药调查分析

目的了解精神分裂症女性住院患者抗精神病药物的临床使用情况,掌握患者的用药剂量。方法对赣州市第三人民医院2012年4月住院的126例女性精神分裂症患者的抗精神病药物使用情况进行统计分析。结果抗精神病药物使用率排在前5位的分别为：利培酮、阿立哌唑、氯氮平、奥氮平、氯丙嗪,前4位均为新型的非典型抗精神病药。以单用抗精神病药为主,使用的剂量适中,而合并用药则以不同作用机制的2种药物联合用药为主。结论非典型抗精神病药物已逐渐成为抗精神病治疗的主要用药,其优势主要为疗效确切,锥体外系综合征等不良反应少,尤其是利培酮使用率较高。典型的抗精神病药如氯丙嗪等由于疗效相对不理想,不良反应大导致使用率低。     

住院精神分裂症患者用药分析

诸多研究表明[1-3],精神卫生问题已经成为我国重大的公共卫生问题和突出的社会问题,已越来越引起人们的关注.目前,有关精神分裂症的治疗方法包括药物治疗、心理治疗、无抽搐电休克治疗等,但临床上仍以药物治疗为主.为了解我院住院精神分裂症患者的用药状况及临床治愈率,作者对在我院出院的精神分裂症患者的临床资料进行了回顾性分析,现将结果报告如下.     

长期服用抗精神病药物患者肝脏B超改变的对照研究

目的：探讨长期服用抗精神病药物治疗精神分裂症患者肝脏改变的B超诊断。方法：对1255例单纯服用抗精神病药物超过2年的精神分裂症患者进行肝脏的B超检查,抽取服药5年以上者472例和服药5年以下者783例进行对照研究,行相关项目的比较。结果：长期服用抗精神病药物治疗的精神分裂症患者肝脏B超异常阳性率为28.05%,脂肪肝的发生率最高（24.70%）,占该组异常阳性率的88.09%。异常阳性率因年龄、病程及服药时间的长短不同而具有显著性差异（P＜0.05）,年老（≥50岁）和病程及服药时间长（≥5年）者阳性率较高;性别和精神分裂症的类型不同肝脏B超异常阳性率差异无统计学意义（P＞0.05）。结论：肝脏B超能明确显示长期服用抗精神病药物患者肝脏的改变,从而证实抗精神病药物对肝脏的损害。     

500例胃病患者B超检查结果分析

自93年以来,三年中对500例胃痛患者作B超检查,与胃镜比较,效果满意,诊断率与胃镜基本相符。现报道如下:     

住院精神病患者采用肝脏彩色多普勒超声的检查结果分析

目的：探讨住院精神病患者采用肝脏彩色多普勒超声检查的结果。方法：选取2018年1月—2020年1月天水市第三人民医院收治的精神分裂症患者80例作为观察组,选取同期80名健康体检人员作为对照组,所有人员进行一年随访,采用抗精神病药物治疗精神分裂症组患者,对比两组的肝脏彩色多普勒超声检查结果。结果：观察组患者随访6个月、随访1年后,肝实质不均匀及脂肪肝发生率均显著高于对照组（P <0.05）,单一用药患者的肝实质不均匀及脂肪肝发生率低于联合用药患者但差异不显著（P> 0.05）。结论：肝脏彩色多普勒超声检查用于住院精神病患者中具有显著的价值,能够对患者肝脏受损程度和受损情况进行全面有效的了解,通过检查结果可以对患者的用药治疗方案进行完善,避免对患者肝脏造成严重的损伤,然而对肝损伤的影响因素众多,单纯的彩色多普勒超声检查无法对病因进行有效的鉴定,需要结合患者的具体情况和生活状态,来辅助分析病因,促进诊断效果的提高。     

月经不调532例B超检查结果分析

月经不调５３２例Ｂ超检查结果分析杨仲方，黄琦１资料和方法本组５３２例月经不调病例，年龄１６～５５岁，平均３１．２岁。受检查者膀胱适度充盈，平卧位，经腹常规于耻骨联合上方作纵横多切面扫查，观察子宫、卵巢、输卵管、子宫直肠窝及盆腔其它地方的情况，有病变者...     

女性精神分裂症伴高泌乳素血症患者泌乳素水平观察分析

目的探讨女性精神分裂症伴有高泌乳素血症患者后泌乳素水平变化。方法选择符合中国精神疾病分类与诊断标准(CCMD-2-R)关于精神分裂症的诊断标准,同时符合高泌乳素血症的诊断标准的患者130例分两组进行利培酮和阿立哌唑治疗,用化学发光法在治疗前后同时对患者组和对照组泌乳素水平进行测定分析。结果治疗后与治疗前比较,对照组血清泌乳素水平无变化;利培酮组患者的血清泌乳素水平显著升高,比较差异有统计学意义(P<0.01);阿立哌唑组患者的血清泌乳素水平无明显升高,比较差异无统计学意义(P>0.05)。结论治疗女性精神分裂症患者时,要充分考虑抗精神病药物对其生理功能的影响。选择对泌乳素影响小的抗精神病药物是关键。     

Occupational therapy for inpatients with chronic schizophrenia: A pilot randomized controlled trial

Aim: People with schizophrenia tend to experience difficulties in social and cognitive function, self‐care, residual negative symptoms, high rates of unemployment, and social exclusion. Occupational therapy has contributed to the treatment and rehabilitation of people with severe mental health problems. Therefore, this study investigated the effects of occupational therapy on symptoms of patients with schizophrenia. Methods: This survey was an experimental study in which positive and negative symptoms of patients with schizophrenia were assessed with a scale for the assessment of positive and negative symptoms (SANS, SAPS, respectively). The study was conducted in Sina Hospital, Shahrekord, Iran. The samples consisted of patients with schizophrenia who were divided randomly into intervention and usual treatment groups (30 patients in each group). The occupational therapy was performed in the intervention group for 18 h/week for 6 months. SANS and SAPS were assessed at the beginning and after 6 months of treatment. Results: The groups were homogeneous in demographic variables, SANS and SAPS scores at baseline. The occupational therapy group showed significant improvement in the total score for the SANS and SAPS at 6 months (P < 0.001), but the control group did not show any significant improvement. Conclusion: The results of this study indicated that occupational therapy combined with medications can improve the symptoms of schizophrenia.     

Impact of audit and feedback on antipsychotic prescribing in schizophrenia

Objective  To examine the impact of audit and feedback on antipsychotic prescribing for schizophrenia outpatients over 4.5 years.
Methods  Clinical files in three mental health services caring for outpatients in Auckland, New Zealand were reviewed at two time-points (March 2000, October 2004). After the first audit, feedback was provided to all three services. Baseline prescribing variations between services were found for antipsychotic combinations and second-generation antipsychotic (SGA) prescribing, in particular clozapine. In two services audit and feedback continued with two interim reviews (October 2001, March 2003). Specific feedback and interventions targeting clozapine use were introduced in both services. No further audit or feedback occurred in the third service until the final audit. Data were collected (patient characteristics, diagnosis, antipsychotic treatment) and analysed at each audit.
Results  Three prescribing variables (antipsychotic monotherapy, SGA and clozapine use) were consistent with practice recommendations at the final audit (85.7%, 82.7% and 34.5% respectively) and had changed in the desired direction for all three services over the 4.5 years. At baseline there were differences between the three services. One service had baseline prescribing variables closest to recommendations, was actively involved in audit, and improved further. The second service, also actively involved in audit had baseline prescribing variables further from recommendations but improved the most. The service not involved in continuing audit and feedback made smaller changes, and SGA and clozapine use at endpoint were significantly lower despite at baseline being comparable to the service which improved the most.
Conclusions  This study found audit and feedback to be an effective intervention in closing the gap between recommended and routine clinical practice for antipsychotic prescribing in schizophrenia.     

阴道B型超声在诊断早期宫外孕中的效果评价

目的探讨经阴道B型超声(B超)在诊断早期宫外孕中的临床应用价值。方法回顾分析2011年5月-2012年3月应用阴道B超与腹部B超对78例宫外孕患者进行对比检查的临床资料并回顾性分析,评价两种检查方法的临床效果。结果 78例宫外孕患者,应用经阴道B超检查诊断准确率为97.44%,应用腹部B超准确率为61.54%,差异具有统计学意义(χ2=6.472,P<0.05);经阴道B超检查诊断附件包块、宫内假孕囊、心血管搏动、胚芽、盆腔积液的检出率明显高于经腹部B超检查的检出率(P<0.05)。结论阴道B超具有操作简单、快速、无副作用、无需充盈膀胱等优点,在宫外孕的早期诊断中具有绝对的优越性,为临床提供了更方便、更快捷的诊断手段,减轻了患者痛苦,提高了诊断的准确率,值得临床广泛推广和应用。     

Insight change and its relationship to subjective well-being during acute atypical antipsychotic treatment in schizophrenia

What is known and Objective: Poor insight is prevalent among patients with schizophrenia and improved insight is one of the major goals of treatment. The purpose of the present study was to examine the relationship between insight and subjective well‐being during acute treatment of schizophrenia with atypical antipsychotics in a naturalistic clinical setting. Methods: Forty inpatients with schizophrenia were examined before and 8 weeks after the initiation of new treatment with atypical antipsychotics. Results: There were significant correlations between changes in insight and those in psychopathology and global functioning. The change in insight score was significantly correlated with that in subjective well‐being score, indicating that the improvement in insight was positively related to improved subjective well‐being. This correlation remained significant even after controlling for the influence of psychopathology. The insight score at baseline was also significantly correlated with the subsequent change in subjective well‐being score. What is new and conclusion: The improvement of insight was positively correlated not only with that of psychopathology and global functioning, but also with that of subjective well‐being, suggesting the potential value of interventions that improve patients’ awareness of the nature of their illness and the need for pharmacological treatment.     

Choice of atypical antipsychotic therapy for patients with schizophrenia: An analysis of a medicaid population

Background:

In patients treated at Veterans Affairs facilities, demographicand clinical characteristics have been found to influence the choice of atypical antipsychotic drugs. However, little is known about the influences on the choice between olanzapine and risperidone in patients with schizophrenia enrolled in Medicaid.

Objective:

The aim of this study was to determine whether demographicand/or clinical characteristics and/or medical-service utilization before treatment were related to the choice of olanzapine versus risperidone therapy using data from a Medicaid population with schizophrenia.

Methods:

The study sample was identified in the North Carolina (NC)Medicaid claims database. Data were included from patients aged 18 to 64 years who were diagnosed with schizophrenia; had initiated treatment with olanzapine or risperidone between July 1, 1998, and October 31, 2000; had not used atypical antipsychotics during the 6 months before the start of treatment; and were continuously eligible in the NC Medicaid program during the 6 months before the start of treatment. Multivariate logistic regression models were used to estimate the likelihood of the choice of olanzapine or risperidone associated with patients' demographic and clinical characteristics and medical-service utilization during the 6 months before the initiation of treatment.

Results:

A total of 764 patients (383 women, 381 men; mean age, 42.1 years)were included in the analysis: 420 were initially prescribed olanzapine and 344 were prescribed risperidone. Men were more likely than women to be prescribed olanzapine compared with risperidone. Patients who had a hospitalization related to a psychiatric condition during the pretreatment period were more likely to be prescribed olanzapine compared with risperidone (OR = 1.530; P = 0.043). Significant regional variation in the likelihood of prescribing olanzapine or risperidone was found, with patients being prescribed risperidone at a higher rate compared with olanzapine in 2 counties with the largest schizophrenic populations.

Conclusions:

In this study of data from patients with schizophrenia identified in the NC Medicaid claims database, sex, a history of psychiatric-related hospitalization, and geographic residence were found to be correlated with the selection of treatment with olanzapine versus risperidone. These findings need to be confirmed in large, randomized, prospective studies.     

65例隐睾症的B超诊断分析

报道６５例隐睾症，术前应用Ｂ超作睾丸定位，测定大小及内部结构有无异常，经与手术后对照符合率约７４％，作者认为Ｂ超对隐睾症有一定的诊断价值     

慢性精神分裂症患者伴发代谢综合症临床研究

目的探讨长期服用氯氮平治疗的慢性精神分裂症患者伴发代谢综合症的发生率及其相关因素。方法对124例长期服用氯氮平治疗的慢性精神分裂症患者的一般资料进行统计整理，并测量身高、体重、腰围和血压，测定空腹血糖、血总胆固醇、甘油三脂、高密度脂蛋白胆固醇和低密度脂蛋白胆固醇及氯氮平血药浓度，对检测结果进行相关分析。结果长期服用氯氮平的慢性精神分裂症患者中糖尿病发生率19．4％、高血压发生率12．1％、肥胖发生率54．0％、血脂紊乱发生率55．600，代谢综合症发生率14．5％，其中女性患者肥胖发生率显著高于男性（P〈0．05）。相关因素分析显示，血压、血脂与性别有关，血压、BMI、血脂及腰围与氯氮平最高剂量有关。结论长期服用氯氮平治疗的慢性住院精神分裂症患者伴发代谢综合症的发生率较高，其与性别及服用氯氮平的最大剂量有关。