精神病患者合并外科急腹症临床分析.docVIP

精神病患者合并外科急腹症临床分析 　　[摘要] 目的：总结精神病患者合并外科急腹症的特点，以及围术期处理要点。方法：设156例精神病患者合并外科急腹症为A组，设同期160例非精神病患者外科急腹症为B组，对两组资料进行回顾性分析，行统计学处理。结果：A组具有无主诉、主诉不正确，症状体征不典型，病史查体资料采集困难，就诊晚、病情变化快，误诊率高，并发症多等特点。两组对照在主诉、腹痛腹胀程度、误诊率、术后并发症方面差异有统计学意义，P＜0.05。结论：诊治精神病合并外科急腹症的患者，应了解其临床特点、早诊断、加强围术期处理、积极果断治疗。若不及时发现和果断处理，往往造成严重后果。 　　[关键词] 精神病；急腹症；围术期；临床分析 　　[中图分类号] R749 [文献标识码]A[文章编号]1674-4721（2011）07（a）-040-03 　　 　　Clinical analysis of psychopaths merger surgical acute abdominal disease 　　CHEN Zhiqiang, DONG Jingnian 　　Huayi Hospital of Changping District, Beijing 102208, China 　　[Abstract] Objective：To summarize the characteristics of mental illness complicated with acute abdomen, and the perioperative main treatment points. Methods: 156 cases of mental illness complicated with surgical acute abdomen as the A group, set up the same period 160 cases of acute abdomen of non-mentally ill as the B group, retrospectived analyzed of two sets of data, and analyzed statistically. Results: A group with no complaints, the main complaint was not correct, signs and symptoms were not typical, history of physical examination data collection difficulties, late treatment, the condition changed quickly, easily misdiagnosed, more complications and so on. The main complaints, abdominal pain, abdominal distention level, the misdiagnosis rate, postoperative complications in the two groups were significantly different, P0.05. Conclusion: Diagnosis and treatment of mental illness complicated with acute abdomen, should be aware of its clinical features, early diagnosis, strengthening perioperative treatment, active and decisive treatment. If the diagnosis and treatment is not timely, it is easy to cause serious consequences. 　　[Key words] Mental illness; Acute abdomen; Perioperative period; Clinical analysis 　　 　　精神病患者为特殊人群，临床发生急腹症并不少见。由于患者存在思维、情感障碍、伴行为异常等精神症状，加上长期服用抗精神病药物和抗胆碱药物，大多患者对疼痛等刺激反应迟钝，因此精神病患者并发急腹症容易延迟诊断或误诊，且有症状复杂多样、术后并发症多[1]等特点。现将本院普外科2000年1月~2010年12月收治156例精神病患者合并急腹症与同期160例非精神病患者急腹症的临床资料及诊治体会报道如下： 　　1 资料与方法