47年精神科住院病人死因及自杀特征分析

目的分析47年来精神科住院病人死亡原因及自杀特征。方法对我院1961—2007年所有住院死亡病例进行回顾性调查研究，将47年分为5个时期进行对比分析，统计采用X。检验。结果精神科住院病人病死率为0．31％，死亡原因主要是躯体疾病（47．30％），其次是自杀（24．32％）和猝死（21．62％）。躯体疾病、自杀不同时期比较病死率差异有统计学意义（P〈0．01或P〈0．05）。自杀者主要采用自缢方式，自缢占总自杀的75．00％；自缢工具以衣服、毛巾为主，地点常发生于厕所，时间多发生于节假日及三休时间，自缢工具、地点、时间各期比较差异无统计学意义（P〉0．05）。结论47年来我院在医疗管理质量、医疗技术水平方面取得了一定成效，但及早发现、及早治疗精神病人的躯体疾病以及掌握精神病人的自杀特征，防止病人自缢，是减少精神科住院病人死亡的关键。

An analysis on death causes and suicide characters for in-patients of psychiatric department during 47 years

Objective To analyze the death causes and suicide characters for in-patients of psychiatric department during 47 years. Methods All the death in-patients during 1961 to 2007 in the hospital were retrospectively Studied. The data of 47 years were divided into 5 periods and were analyzed with X2 test. Results The death rate of psychiatric department in-patients was 0.31%. The death cause was somatic diseases first（47.30% ）, suicide （24.32%） and sudden death （21.62%） next. The death rate ,somatic diseases and suicide showed significant differences among different years （ P 〈 0.01 or P 〈 0.05 ）. Suicide mode was mainly hanging oneself. Most of hanging tools were clothes and towel. The hanging site usually was in toilet. The hang- ing time was mainly at duration of holiday and three rest times or non-working time. The hanging tools, the hanging site and the hanging time showed no significant differences among different years （P 〉 0.05）. Conclusion During 47 years, the levels of hospital management and medical technology in our hospital had made great achievements. But, earlier finding and timely intervention somatic diseases, and grasping suicide characters, preventing patient from suiciding were the key to decrease the death rate of psychiatric department in-patients.