北京市某城区有危险行为精神障碍患者应急医疗处置分析
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摘要
目的分析精神障碍患者应急医疗处置案例,为社区处置应急事件提供科学依据。方法对北京市某城区2016年1月～2017年12月201例危险评估1～5级精神障碍患者应急医疗处置工作现场记录表进行统计、分析、评估。结果 201例患者实施应急处置中,在册患者163例,非在册38例,危害自身/他人安全事件或倾向152例,占75.62%,危险评估1级156例,占77.62%,≥2级45例,占22.39%。发生1次应急处置的患者186人次,≥2次15人次。结论在应急医疗处置中以危害自身/他人安全事件或倾向事件为主。做好社区应急医疗处置工作,能有效控制和减少严重精神障碍患者危险行为的发生,维护社会安全。
Objective To analyze the emergency medical treatment cases of patients with mental disorders and provide scientific basis for the community to deal with emergencies. Methods Emergency medical treatment work site record tables of 201 mental illness patients with grade 1 to 5 mental disorders from January 2016 to December 2017 in a city district of Beijing were counted, analyzed and evaluated. Results Among the 201 patients with emergency treatment,163 were enrolled in the study, 38 were non-invented, 152 cases were at risk of their own/others' safety events or propensity, accounting for 75.62%. 156 cases were at grade 1 and accounting for 77.62%, 45 cases at risk greater than or equal to grade 2, accounting for 22.39%. One emergency disposal occurred for 186 person-times, ≥2 emergency disposal occurred for 15 person-times. Conclusion Endangering one's own/other person's safety incident or tendency event is the main thing in the emergency medical treatment. To do a good job in emergency medical treatment in the community can effectively control and reduce the occurrence of dangerous behavior in patients with severe mental disorders and maintain social security.
Objective To analyze the emergency medical treatment cases of patients with mental disorders and provide scientific basis for the community to deal with emergencies. Methods Emergency medical treatment work site record tables of 201 mental illness patients with grade 1 to 5 mental disorders from January 2016 to December 2017 in a city district of Beijing were counted, analyzed and evaluated. Results Among the 201 patients with emergency treatment,163 were enrolled in the study, 38 were non-invented, 152 cases were at risk of their own/others' safety events or propensity, accounting for 75.62%. 156 cases were at grade 1 and accounting for 77.62%, 45 cases at risk greater than or equal to grade 2, accounting for 22.39%. One emergency disposal occurred for 186 person-times, ≥2 emergency disposal occurred for 15 person-times. Conclusion Endangering one's own/other person's safety incident or tendency event is the main thing in the emergency medical treatment. To do a good job in emergency medical treatment in the community can effectively control and reduce the occurrence of dangerous behavior in patients with severe mental disorders and maintain social security.
引文
[1]中华人民共和国卫生和计划生育委员会.国家基本公共卫生服务规范(第三版)[S].北京,2017.
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[12]彭建燕,何昌九.社区精防人员参与严重精神障碍应急医疗处置调查分析[J].医药卫生,2016,(6):235.
[13]王维丹,付永利,徐松泉.浙江省严重精神障碍应急医疗处置培训现状与需求的调查分析[J].中国乡村医药,2017,24(11):60-61.
[14]姚丰菊,王长江,秦志华,等.农村重性精神障碍患者应急医疗处置机制探讨[J].中国医药科学,2014,4(1):173.
[15]冯斯特,刘素珍.国内重性精神疾病患者社区管理现状与对策[J].中华护理杂志,2014,49(6):764-768.
[16]关慧娟.重性精神病人社区防治管理模式及应用[J].现代诊断与治疗,2017,28(18):3498-3500.
[17]丁晓烨,国文利,晁娜,等.北京市顺义区重性精神疾病现况调查分析[J].医学综述,2018,24(2):413-416.
[18]张国林,梁成智,李芳.定西市2010~2012年重性精神疾病流行特征分析[J].西部中医药,2016,29(1):88-90.
[19]余伟,黎海云,陈梓朗.医院-社区-体化防治护理对社区重性精神病患者康复的影响[J].中国当代医药,2017,24(28):64-66.
[2]卫生部办公厅关于做好重性精神疾病监管治疗项目实施工作的通知.重性精神疾病监管治疗项目管理办法[S].(卫办疾控发[2006]80号),北京,2006.
[3]全国人民代表大会常常务委员会.中华人民共和国精神卫生法[S].北京,2012年10月26日通过,2013年5月1日起施行.
[4]沈渔邨.精神病学[M].北京:人民卫生出版社,2009:1-1045.
[5] WHO. ICD-10精神与行为障碍分类:临床描述与诊断要点[S]. 2010.
[6]梁映,刘敏东.南宁市兴宁区肇事肇祸重性精神疾病患者情况调查[J].临床精神医学杂志,2012,22(4):246-248.
[7]庄开岑,殷濛濛,张宴萍,等.社区重性精神疾病患者个案管理效果分析[J].中国民康医学,2015,27(19):92-93,130.
[8]朱韶敏,赵明,张玲,等.社区重性精神疾病患者应急处置的探讨214人次[J].中国社区医师,2012,14(32):144-145.
[9]关于印发《北京市门诊使用免费基本药品治疗严重精神障碍管理办法(试行)》的通知[S].京卫精卫字[2013]9号,北京,2015.
[10]北京市《严重精神障碍患者监护人申领看护管理补贴的暂行办法》[S].京卫疾控[2015]116号,北京,2016.
[11]北京市《〈严重精神障碍患者监护人申领看护管理补贴的暂行办法〉实施细则》[S].京卫疾控[2016]4号,北京,2016.
[12]彭建燕,何昌九.社区精防人员参与严重精神障碍应急医疗处置调查分析[J].医药卫生,2016,(6):235.
[13]王维丹,付永利,徐松泉.浙江省严重精神障碍应急医疗处置培训现状与需求的调查分析[J].中国乡村医药,2017,24(11):60-61.
[14]姚丰菊,王长江,秦志华,等.农村重性精神障碍患者应急医疗处置机制探讨[J].中国医药科学,2014,4(1):173.
[15]冯斯特,刘素珍.国内重性精神疾病患者社区管理现状与对策[J].中华护理杂志,2014,49(6):764-768.
[16]关慧娟.重性精神病人社区防治管理模式及应用[J].现代诊断与治疗,2017,28(18):3498-3500.
[17]丁晓烨,国文利,晁娜,等.北京市顺义区重性精神疾病现况调查分析[J].医学综述,2018,24(2):413-416.
[18]张国林,梁成智,李芳.定西市2010~2012年重性精神疾病流行特征分析[J].西部中医药,2016,29(1):88-90.
[19]余伟,黎海云,陈梓朗.医院-社区-体化防治护理对社区重性精神病患者康复的影响[J].中国当代医药,2017,24(28):64-66.