轻性精神疾病对躯体疾病患者病情的影响分析
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摘要
目的观察轻性精神疾病患者对不同躯体疾病患者病情的影响,为临床轻性精神疾病合并躯体疾病患者的诊治提供参考。方法选择我院门诊于2015年3月—2016年3月期间诊治的124例轻性精神疾病合并躯体疾病患者作为研究对象,设为观察组。选择同期诊治的124例不伴有精神疾病的躯体疾病患者设为对照组。两组患者分别根据患者实际情况采用精神疾病和合并躯体疾病临床诊疗指南进行治疗,并按照孙传兴编著的临床疾病诊断依据治愈好转标准(第二版)判断治疗预后。比较两组患者中不同躯体疾病患者的治愈率、好转率、复发率。结果对照组和观察组患者的年龄、性别、文化背景、躯体疾病类型比较差异无统计学意义(P>0.05)。两组患者经过临床规范治疗后,观察组患者不同躯体疾病治愈率和好转率与对照组相同躯体疾病患者比较,差异无统计学意义(P>0.05),但观察组患者所有类型躯体疾病患者的复发率均明显高于对照组同类躯体疾病患者,组间比较差异有统计学意义(P<0.05)。治疗结束后至随访期间,观察组患者完全遵医率明显低于对照组,组间比较差异有统计学意义(P<0.05)。结论轻性精神疾病患者的躯体疾病病情进展和单纯躯体疾病患者之间存在差异,临床医护人员在诊治轻性精神疾病合并躯体疾病患者时,应重视精神疾病对躯体疾病的影响,酌情调整治疗方案,确保患者预后良好。
Objective To observe the effect of mild mental illness on the condition of patients with physical diseases,to provide reference for clinical diagnosis and treatment. Methods We selected 124 cases of patients with mild mental illness combined with physical diseases in our hospital from March 2015 to March 2016 as the research objects,and set up as the observation group. 124 patients with physical diseases but without mental illness were selected as the control group. Based on the actual situation of patients in the two groups,clinical guidelines of mental disorders and physical diseases were adopted to the treatment,and according to the clinical disease diagnosis based on cure and improvement standard edited by Sun Chuanxing( Second Edition),we judged the prognosis conditions. And then the cure rate,improvement rate and recurrence rate were compared between the two groups of patients with physical diseases. Results There were no significant differences in age,sex,culture background,and physical disease types in the control group and the observation group( P > 0. 05). After the clinical standard treatment,compared with patients with the same physical diseases in the control groups,it had no statistically differences in cure rate and improvement rate of the patients with different physical diseases( P > 0. 05),but all types of physical disease recurrence rate of patients in the observation group was significantly higher than that of the control group,there was statistically difference between the two groups( P < 0. 05). After the end of treatment to the follow-up period,the rate of patients' completely following the medical treatment in the observation group was significantly lower than that in the control group,and the difference was statistically significant( P < 0. 05). Conclusion There is progressive difference between patients with mild mental illness combined with physical diseases and patients with only physical diseases. When the clinical medical personnel are faced with the diagnosis and treatment of patients with mild mental illness combined with physical diseases,they should pay attention to the impact of mental illness on the physical diseases,and adjust the treatment plan appropriately in order to ensure a good prognosis of patients.
Objective To observe the effect of mild mental illness on the condition of patients with physical diseases,to provide reference for clinical diagnosis and treatment. Methods We selected 124 cases of patients with mild mental illness combined with physical diseases in our hospital from March 2015 to March 2016 as the research objects,and set up as the observation group. 124 patients with physical diseases but without mental illness were selected as the control group. Based on the actual situation of patients in the two groups,clinical guidelines of mental disorders and physical diseases were adopted to the treatment,and according to the clinical disease diagnosis based on cure and improvement standard edited by Sun Chuanxing( Second Edition),we judged the prognosis conditions. And then the cure rate,improvement rate and recurrence rate were compared between the two groups of patients with physical diseases. Results There were no significant differences in age,sex,culture background,and physical disease types in the control group and the observation group( P > 0. 05). After the clinical standard treatment,compared with patients with the same physical diseases in the control groups,it had no statistically differences in cure rate and improvement rate of the patients with different physical diseases( P > 0. 05),but all types of physical disease recurrence rate of patients in the observation group was significantly higher than that of the control group,there was statistically difference between the two groups( P < 0. 05). After the end of treatment to the follow-up period,the rate of patients' completely following the medical treatment in the observation group was significantly lower than that in the control group,and the difference was statistically significant( P < 0. 05). Conclusion There is progressive difference between patients with mild mental illness combined with physical diseases and patients with only physical diseases. When the clinical medical personnel are faced with the diagnosis and treatment of patients with mild mental illness combined with physical diseases,they should pay attention to the impact of mental illness on the physical diseases,and adjust the treatment plan appropriately in order to ensure a good prognosis of patients.
引文
[1]马琼芳,陈海勤,沈建斌,等.精神病专科医院精神科住院患者躯体疾病综合科会诊3年情况分析[J].浙江医学,2014(19):1651-1653.
[2]谢丹.伴躯体疾病流浪精神病患者的临床特征及护理对策[J].基层医学论坛,2014(6):712-713.
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[5]邓先华,张美燕,毕建强,等.流浪精神病患者合并躯体疾病调查[J].临床精神医学杂志,2014(4):265-266.
[6]黄凤霞,严要苗,陈丽坚,等.伴急重症躯体疾病精神病患者精神障碍的观察及护理对策[J].齐齐哈尔医学院学报,2014,35(13):2006-2007.
[7]李晓燕,王晓静,邬宏,等.ICU中精神病患者的躯体疾病类型及护理[J].中国民康医学,2016,28(1):83-84;95.
[8]闫海莲.运动训练法干预治疗中轻度抑郁症患者23例[J].中国老年学,2014(17):4963-4964.
[9]李宏伟,狄朝晖.大学生焦虑症的早期发现与运动疗法干预[J].中外健康文摘,2011,08(28):445-447.
[10]熊贵芬,彭国美,向贵英,等.品管圈活动在精神病合并躯体疾病患者中的管理效果研究[J].西南国防医药,2015(6):668-669.
[2]谢丹.伴躯体疾病流浪精神病患者的临床特征及护理对策[J].基层医学论坛,2014(6):712-713.
[3]孙传兴.临床疾病诊断依据治愈好转标准(第二版)[M].北京:人民军医出版社,2002.
[4]张红旗.住院精神病患者并发内科重症80例临床资料分析[J].临床心身疾病志,2015(2):135-136.
[5]邓先华,张美燕,毕建强,等.流浪精神病患者合并躯体疾病调查[J].临床精神医学杂志,2014(4):265-266.
[6]黄凤霞,严要苗,陈丽坚,等.伴急重症躯体疾病精神病患者精神障碍的观察及护理对策[J].齐齐哈尔医学院学报,2014,35(13):2006-2007.
[7]李晓燕,王晓静,邬宏,等.ICU中精神病患者的躯体疾病类型及护理[J].中国民康医学,2016,28(1):83-84;95.
[8]闫海莲.运动训练法干预治疗中轻度抑郁症患者23例[J].中国老年学,2014(17):4963-4964.
[9]李宏伟,狄朝晖.大学生焦虑症的早期发现与运动疗法干预[J].中外健康文摘,2011,08(28):445-447.
[10]熊贵芬,彭国美,向贵英,等.品管圈活动在精神病合并躯体疾病患者中的管理效果研究[J].西南国防医药,2015(6):668-669.