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61例住院患者死亡的案例分析(1)
http://www.100md.com 2015年2月15日 中国医学创新 2015年第5期
     【摘要】 目的:分析本院20年来出院病例院内死亡的原因和规律,以采取相应措施,减少死亡的发生。方法:调查本院1995年7月1日-2014年6月30日精神科全部死亡病例61例,其中院外死亡19例,院内死亡42例,院内死亡男32例,女10例,年龄25~77岁,平均53岁,以31~50岁居多,病程以16~20年居多,诊断精神分裂症人数为高。结果:突发性猝死12例(28.57%);合并症衰竭死亡8例(19.05%);噎食窒息6例(14.29%);自杀死亡5例(11.90%);各系统癌症4例(9.52%);感染性休克4例(9.52%);器质性死亡3例(7.14%)。又发现合并症衰竭死亡,均发生在2005年1月1日以前(P<0.01),各系统癌症及器质性疾病死亡的案例多发生在2005年1月1日之前(P>0.05),近10年噎食窒息死亡有所增加(P>0.05)。结论:随着医护人员医疗技术和安全意识的提高,合并症等疾病及时发现及时转院诊治,减少衰竭死亡率,噎食窒息注意短时间内药物剂量的控制,减少药物的副反应,减少死亡率,对慢性患者合并症的有所增加,适当减少用药剂量或换用新型抗精神病药物,减少致命的副作用意外发生。同时加强精神患者的监护,安全设施的保证,严防自杀行为的发生。
, 百拇医药
    【关键词】 院内死亡病例; 死亡原因; 措施

    【Abstract】 Objective:To analyze the causes and regularity of patients who had gone out of our hospital and then died in it over the 20 years,to take reasonable measures to reduce the death.Method: The data of 61 cases of death of the psychiatric from July 1st,1995 to June 30 th, 2014 were surveyed,among them 19 cases died outside the hospital, 42 cases died in the hospital, and 32 cases were male, 10 cases were female,with an average age of 53(25-77), in the majority with 31-50, the course of the disease were most between16 and 20 years, the number of the diagnosis of schizophrenia was high.Result:Sudden death were 12 cases (28.57%). Death of Combined diseases were 8 cases (19.05%); death of Choke food were 6 cases (14.29%); suicide death were 5 cases (11.90%); each system cancer were 4 cases (9.52%); septic shock were 4 cases (9 52%);organic died 3 cases (7.14%). And combined disease was found some death, had occurred before January 1,2005(P<0.01),all cases of each system cancer and organic disease died before January 1,2005(P>0.05),in recently 10 years choke food’s death increased(P>0.05).Conclusion:With the improvement of medical technology and safety consciousness, combined disease with all the disease are found in time and patients are transferred in time.Which can reduce the death.Control the quantity of the drugs for choke food patients in a short period of time,reduce the drug adverse reactions, reduce the rate of death.For the increase of the chronic complications patients,decrease the quantity or change to a new type of anti-psychotic drugs,reduce the opposite fatal effects.At the same time strengthening the care for mental patients,the assurance of safety facilities,fight the occurrence of suicidal behavior.

    【Key words】 Hospital death cases; Cause of death; Measures

    本院为专科医院,精神疾病患有各系统疾病即合并症时,需转院或会诊治疗,在治疗精神疾病过程中抗精神病药物发挥双刃剑作用,即有抗精神病作用,同时也有相应的副反应,其副作用从中枢到外周,广泛而复杂。为了对此深入了解,以指导临床安全用药,笔者对本院20年来在院内突发死亡病案进行临床分析。, http://www.100md.com(刘淑娟 谢宪平)
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