精神科药物 [413例精神科住院患者精神药物使用时点调查]

　　[摘要] 目的 了解我院精神科住院患者精神药物使用情况及其合理性。 方法 利用北京市安康医院HIS系统查阅2011年2月17日精神科住院患者精神药物用药情况，于18∶00时进行用药时点调查。 结果 413例精神科住院患者中407例使用抗精神药物，涉及24种药物，单一用药物者225例（55.28%），其中，使用利培酮片（卓菲、可同、维思通）81例（36.00%），阿立哌唑片51例（22.67%），氯氮平33例（14.67%）；联合用药者182例。两种药物联合应用患者中苯二氮■类（劳拉西泮、氯硝西泮、硝西泮、地西泮、艾司唑仑）与其他药物联合应用者66例（41.51%），利培酮联合扎来普隆21例（13.21%）；三种药物联合应用者23例，苯二氮■类+利培酮+其他药物联合应用者8例（34.78%），扎来普隆联合应用者6例（26.09%）。 结论 北京市安康医院精神科住院患者精神药物使用较为合理，新型非典型抗精神药物的使用正逐渐增多，医生应恪守从单一用药的原则出发，尽量减少多种药物联合应用。
　　[关键词] 时点调查；精神科；住院患者；精神药物
　　[中图分类号] R749 [文献标识码] C [文章编号] 1673-7210（2012）07（a）-0119-02
　　Time survey of psychotropic drugs use among 413 inpatients in psychiatric department
　　ZHOU Yanpu1 FENG Changjun1 DAI Jin2
　　1.Department of Pharmacy, Beijing Ankang Hospital, Beijing 101300, China; 2.Department of Emergency, the Second Hospital of Beijing Armed Police Corps, Beijing 100037, China
　　[Abstract] Objective To understand the use condition and its rationality of psychotropic drugs in inpatients of psychiatric department in our hospital. Methods The use condition of psychotropic drugs in inpatients of psychiatric department at 18:00 on February 17, 2011 was investigated by the hospital information system (HIS) of Beijing Ankang hospital. Results Among 413 inpatients in the psychotropic department, 407 used antipsychotics, involved 24 kinds of drugs. 225 patients (55.28%) were given single drug, of whom 81 patients (36.00%) used Risperidone Tablets (Zhuofei, Ketong, Risperdal), 51 patients (22.67%) used Aripiprazole Tablets and 33 patients (14.67%) used Clozapine. 182 patients were given combination drugs. Among the two-drugs combination, benzodiazepines (Lorazepam, Clonazepam, Nitrazepam, Diazepam, Estazolam) combined with other drugs were used in 66 patients (41.51%) and Risperidone + Zaleplon were used in 21 patients (13.21%). Among the three-drugs combination, benzodiazepines + Risperidone + other drugs were used in 8 patients (34.78%) and Zaleplon combination was used in 6 patients (26.09%). Conclusion The use of psychotropic drugs among the inpatients in the psychiatric department of Beijing Ankang Hospital is rational and the use of new atypical antipsychotics increases gradually. However, doctors should adhere to the principle of using single drug first and reduce the multi-drug combination.
　　[Key words] Time survey; Psychiatric department; Inpatients; Psychotropic drugs
　　我院属于北京市公安局直属三级医院，专门收治肇事肇祸精神患者，一般住院时间长甚至终身住院，随着住院时间的推移，患者会出现躯体疾病、用药不良反应等情况，导致病情复杂，治疗难度大。患者的特殊性往往给医生下医嘱带来诸多困扰，因此，合理使用抗精神病药物，减少不良反应，了解我院精神科住院患者精神药物使用情况及其合理性尤为重要，为此笔者对我院精神科住院患者精神药物使用情况进行了时点调查，现总结报道如下：