住院流浪精神病患者乙肝、梅毒、艾滋病检测结果的对照研究

目的了解住院流浪精神病患者乙肝、梅毒、艾滋病感染的情况,为预防控制和治疗提供参考依据。方法对2011年1月至2012年12月期间住我院148例流浪精神病患者进行TPPA,乙肝五项,抗HIV抗体的血清检测,以同期正常住院的284例精神病患者为对照组,并对检测结果进行统计学分析。结果流浪组的TPPA、HBsAg、HBV总感染阳性率大于对照组(P<0.05),流浪组男女之间各个抗原抗体比较则未发现统计学差异(P>0.05)。结论流浪精神病患者是乙肝、梅毒的高危人群,应常规对新入院流浪精神病患者进行乙肝、梅毒、艾滋病的抗原抗体检测,加强监管,积极预防和治疗。     

435例流浪救助精神病患者临床因子分析

武汉市优抚医院一直承担武汉市救助站和“110”的精神疾病初筛诊治工作,同时也对其他病种的防控工作。下面将435例流浪精神病患者及其他病种的临床资料进行分析,给民政所属医院单位临床科室的构建提供参考,同时也促进兄弟医疗单位的沟通共识,以期政府及社会予以更多经济支持。     

深圳市流浪精神病患者危急值数据分析和临床意义

目的分析深圳市精神病专科医院危急值数据,并探讨其在流浪精神病患者中的应用价值。方法回顾性分析2016年5月～2018年5月深圳市精神病专科医院救助的流浪精神病患者《危急值报告登记簿》的记录内容,包括患者姓名、年龄、性别、住院号、标本接收时间、检验项目、检查结果、报告人、报告时间等。统计2年内危急值发生类型及发生率。结果深圳市精神病专科医院救助的流浪精神病患者2年内发生危急值项目共8项(血清钾、血药浓度偏高、白细胞、肌钙蛋白、血肌酐、血清锂、成人空腹血糖、脑疝),总计68例,发生率高的前5项为血清钾(33.93%)、血药浓度偏高(19..05%)、白细胞(14.29%)、肌钙蛋白(13.10%)、血肌酐(11.90%)。结论深圳市精神病专科医院救助的流浪精神病患者检验危急值以血清钾、白细胞减少、血药浓度、肌钙蛋白、血肌酐偏高等为主;于深圳市精神病专科医院进行危急值数据分析,在促进流浪精神病患者危急值报告持续改进、提高医院医疗安全中具有重要意义。     

流浪精神分裂症患者抗精神病药物使用的性别差异

目的调查我院流浪精神分裂症患者抗精神病药物使用的性别差异。方法采用一日法,以2012年2月18日为时间节点,对我院流浪精神分裂症住院患者(男159例,女111例)的治疗情况进行对比研究。结果①单一使用抗精神病药物:占首位(男性为57.2%,女性为79.3%);联用两种以上抗精神病药物者男性为42.8%,女性为20.7%,男性明显多于女性,差异有统计学意义(P<0.001)。②男性使用抗精神病药物排在前3位的是:利培酮,氯丙嗪,舒必利;女性使用抗精神病药物排在前3位的是:利培酮,氯氮平,氯丙嗪;无重大剂量用药者。③抗精神病药物日均剂量折算为氯丙嗪剂量后,男性与女性比较差异无统计学意义(P>0.05)。结论本调查提示,目前,我院流浪精神分裂症患者抗精神病药物的使用情况比较规范合理,在联合用药方面及部分药物使用频度方面存在性别差异,日均剂量方面性别差异无统计学意义。     

我院收治的精神病流浪患者临床诊疗分析

目的回顾分析我院收治的精神病流浪患者症状特点及诊疗情况。方法对收治患者进行一般人口资料统计;采用PANSS进行评定。结果147例符合Ⅱ型精神分裂症诊断标准,女性比例低于男性,精神分裂症患者以阴性症状为主,治疗效果差。结论流浪Ⅱ型精神分裂症患者是社会流浪现象主要原因之一,需要多部门进一步加强合作,共同治理。     

急性心肌梗死患者QT间期离散度的临床价值

目的：通过观察急性心肌梗死（AMI）患者QT间期离散度（QTd）变化,探讨其与临床关系。方法：应用体表同步十二导联心电图对60例AMI患者进行入院后第一次心电图QTd和校正QT间期离散度（QTcd)测定,并与50例正常人做对照。结果：（1）AMI患者入院后第一次心电图的QTd、QTcd均明显长于对照组（P＜0．01）。（2）死亡组QTd、QTcd均明显长于生存组（P＜0．01）。（3）室性心律失常组QTd、QTcd明显长非心律失常组（P＜0．01）。（4）心衰组QTd、QTcd亦明显长于非心衰组（P＜0．01）。结论：AMI患者QTd、QTcd明显延长,提示AMI患者心肌存在明显电不稳定和复极的不同步性。其不失为AMI发生心脏事件和猝死简单而实用的重要预测指标。     

药物结合康复训练对流浪乞讨精神病患者预后的影响

流浪乞讨精神病患者因其特殊性所表现出的精神症状严重而复杂[1],常常有肇事行为和倾向,对社会治安、居民正常生活秩序造成严重影响[2]。他们不仅存在经济、精神问题,而且长期的社会隔离生活,使他们职业技能和生活技能等社会功能缺乏,由于社会歧视所引发的社会心理问题也相当突出[3]。由于相关救助机构对此类患者救治的局限性,致使患者仅得到一     

927例女性城市流浪精神病患者情况分析与护理对策

目的调查分析女性城市流浪精神病患者情况,并提出相应的护理对策。方法对我院2010年1月至2012年5月收治的927例女性城市流浪精神病患者进行调查、总结、分析情况。结果多数患者难以沟通,无法获得基本情况（57．8％）;外伤及皮肤感染（60％）、传染病（14．2％）、受性侵犯（39．1％）甚至怀孕等情况较为严重。结论女性城市流浪精神病患者来源复杂,存在严重的问题,要高度重视,要针对其存在的问题的特殊性,有的放矢地采取措施,更好地救护患者、保护医护人员。     

脑卒中后精神障碍临床分析

目的探讨脑卒中后精神障碍的临床特点。方法分析110例脑卒中后精神障碍患者的临床资料。结果脑卒中后精神障碍占同期脑卒中住院患者的50．6％（110／217）;精神症状以情感障碍多见,占45．5％（50／110）,其中出现抑郁状态的患者15例。在积极治疗基础疾病的前提下,采用抗精神病药物和心理治疗相结合的方式进行治疗,精神症状很快消失。结论脑卒中后精神障碍在临床上较为常见,以60岁以上的群体为多,严重影响了患者的身心健康,理应引起重视。     

Zuclopenthixol and haloperidol in patients with acute psychotic states. A double-blind, multi-centre study.

A double-blind, multi-centre study was carried out in 49 hospitalized patients with an acute psychosis or an exacerbation of a chronic psychosis to compare the wanted and unwanted effects of the neuroleptics, zuclopenthixol and haloperidol. Patients were allocated at random to receive treatment with one or other of the trial drugs for 8 weeks or until discharge. Five patients on zuclopenthixol and 6 on haloperidol were excluded from the efficacy analyses because they did not complete a minimum of 4-weeks' treatment. Dosage was chosen and adjusted to the individual patient's condition and response. The average daily doses in Week 4 were 33.5 mg and 10.3 mg, respectively. Clinical assessments, including CGI, BPRS and the UKU side-effect scale, were done at baseline, and after 1, 2, 4, 6 and 8 weeks of treatment or at discharge if the patient was discharged earlier than Week 8. Both treatments caused a significant reduction in scores with no between-group differences. More patients in the zuclopenthixol group were discharged early indicating slightly more rapid onset of action. Zuclopenthixol caused a significantly greater improvement in 'anxious-depression' factor score than haloperidol. The most frequent unwanted effects were extrapyramidal symptoms and there were no significant differences between the groups. The extrapyramidal symptoms tended to be transient in the zuclopenthixol group, but not in the haloperidol group. The study confirmed that both zuclopenthixol and haloperidol were effective drugs in the treatment of acute, psychotic patients. There was a trend towards a slightly more rapid onset of effect and a somewhat stronger anxiolytic-antidepressant effect by zuclopenthixol compared to haloperidol.     

认知行为干预对流浪精神病患者的护理效果评价

目的探讨认知行为干预用于流浪精神病患者中的价值。方法将120例流浪精神病患者纳入研究,用随机数字表法分为观察组和对照组,对照组行常规干预,观察组行认知行为干预,对比两组干预前、干预1个月、干预2个月患者自知力与治疗态度问卷量表(ITAQ)分值、健康知识得分、精神病人康复疗效量表(IPROS)及阴性症状量表(SANS)分值。结果 1个月时、2个月时观察组ITAQ分值上升且高于对照组;干预1个月及2个月时观察组健康知识得分较对照组高;干预2个月时观察组IPROS、SANS分值均较低且低于对照组,差异有统计学意义(P 0.05)。结论认知行为干预能有效改善流浪精神病患者自知力与治疗态度,增加患者康复知识,改善其阴性症状,对康复有一定作用。     

Thioproperazine: A study of its use in psychotic excitation

Summary Fifty male patients, with ages ranging from 24 to 78-years, suffering from diverse psychotic disorders, but having in common acute excitation as the chief symptom, were treated with thioproperazine. In a great majority, the drug was given intramuscularly in the first instance, and orally thereafter. Of the total number, 43 responded excellently; 6 improved; and 1 failed to benefit. Side-effects, taking the form of a type of laryngospasm, occurred in 3 patients; these were readily controlled by administration of promethazine hydrochloride intramuscularly and by variation of the thioproperazine dosage. It was noted that all 3 patients were below 25 years of age. The main objects of the trial — to see whether the drug offered advantages, such as faster response and reduction of time spent in hospital, over other methods — were fulfilled; and the more academic object — that of studying the paradoxical contrast between the given pharmacological findings and the clinical — was considered and discussed.We concluded that thioproperazine, if handled properly, is a safe and very valuable drug in the management and treatment of all forms of psychotic excitement.     

Pharmacokinetics of haloperidol in psychotic patients

Nine psychotic patients under continuous oral treatment with haloperidol were randomly given a test dose of 1.5–5 mg haloperidol orally and/or intravenously. Serum levels of haloperidol were determined by high performance liquid chromatography and serum concentration data obtained were submitted to pharmacokinetic analysis. The steady state concentration ratio between blood and plasma was determined and found to be 0.79±0.03. The blood clearance was then calculated to be 550±133 ml/min. The mean hepatic extraction ratio was intermediate (0.37). Consequently, for a drug mainly eliminated by hepatic metabolism like haloperidol, the total blood clearance and the extent of oral bioavailability can be affected by changes in hepatic blood flow, hepatic enzyme activities and drug binding. During continuous oral treatment with haloperidol, however, it can be shown that changes in the total metabolic capacity of the liver due to hepatic enzyme induction or inhibition should be important for the therapeutic effects of haloperidol. The volume of distribution at steady state (Vdss) was large (7.9±2.5 l/kg). The terminal half-life was 18.8 h after intravenous and 18.1 h after oral administration. The oral bioavailability (0.60±0.18) were in accordance with previous results in healthy subjects. A mean lag time after oral dose was 1.3±1.1 h and a longer absorption half-life (1.9±1.4 h) was found in the patients compared with healthy volunteers.     

平板运动试验中Q—Td、Q—Tcd的变化及对比分析

目的 :了解Q-Td、Q -Tcd对活动平板运动试验结果判断的价值。方法 :对30例平板运动试验阳性者及30例平板运动试验阴性者运动试验不同阶段的Q-Td、Q-Tcd进行对比分析。结果 :运动前两组Q-Td、Q-Tcd无显著差异 ;运动后2分钟及运动中或运动后ST段压低最明显时 ,运动试验阳性组与阴性组比较Q-Td、Q -Tcd差异有显著性 (P<0 01) ;阳性组运动后2分钟、运动中或运动后ST段压低最明显时Q-Td、Q-Tcd较运动前显著延长 (P<0 01) ;阴性组运动后2分钟Q-Td、Q-Tcd与运动前相比差异无显著性 (P>0 05)。结论 :运动试验后Q-Td、Q-Tcd延长可作为判断运动试验结果的参考指标     

癔病性躯体障碍与神经官能症躯体形式障碍临床特征对照分析

目的 对照分析癔病性躯体障碍与躯体形式障碍临床特征的差异。方法 采用焦虑、抑郁症自评量表（SAS、SDS）以及自编临床特征调查表分别对26例癔病性躯体障碍和24例躯体形式障碍患者进行调查分析。结果 两组患者在起病形式、诱因、病程特点、性别、主诉症状、药物选择等方面存在明显差异（P〈0．05）。结论 癔病性躯体障碍与躯体形式障碍患者临床差异明显,这些差异有助于两者的鉴定。     

博思清与维思通治疗精神分裂症对照研究

目的探讨博思清(阿立哌唑)治疗精神分裂症的疗效及副作用。方法用博思清与维思通治疗精神分裂症各20例作为对照研究,采用阳性症状与阴性症状量表(PANSS)、不良反应症状量表(TESS)评定疗效及副作用。结果博思清组有效率86%,显效率78%;维思通组有效率82%,显效率71%。博思清组以兴奋激越等副反应为主,维思通组以锥体外系反应为主。结论该两种药物对治疗精神分裂症均有确切疗效,且安全性相对较高,博思清改善阴性症状效果明显,而维思通对阳性症状的控制更好些。