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題 名 | 某綜合醫院灼傷中心患者精神科照會之臨床特徵=Clinical Characteristics of Burn Patients Referred for Psychiatric Consultation |
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作 者 | 邱念睦; 陳添興; 李昱; 劉嘉逸; | 書刊名 | 臺灣精神醫學 |
卷 期 | 11:2 1997.06[民86.06] |
頁 次 | 頁63-72 |
分類號 | 415.989 |
關鍵詞 | 灼傷; 精神科照會; 綜合醫院; 灼傷中心; Burn; Psychiatric consultation; General hospital; Burn center; |
語 文 | 中文(Chinese) |
中文摘要 | 目地:本文探討灼傷加護中心之精神科照會相關因素。方法:於1992年6月至1994年5月底,南部某醫學中心二年內所有灼傷病患523人中,精神科照會醫師每週診視被要求照會之 42 名個案後,分析影響灼傷照會之相關因素、照會原因與精神診斷之關係、初次及追蹤照會結果。結果:照會率為 8.03%,達超過綜合醫院平均照會率 (0.72~1.7%)。影響照會率之客觀因素有灼傷面積大小,住院天數及灼傷種類,照會率較高者為燒傷、面積較大及住院天數較長者,照會率較低者為燙傷 (P<0.001)。第一次照會精神科之42名個案診斷中,29位為適應障礙合併焦慮或憂鬱情緒,6 位診斷為譫妄, 5 位為酒精或藥物濫用,有2位為功能性精神病。因焦慮、憂鬱等情緒問題而照會者,精神診斷多為適應性疾患;因精神症狀或行為問題而照會者,診斷多為上述其他診斷。 經追蹤照會結果,29位診斷為適應障礙合併焦慮或憂鬱情緒中,有5位(17.2%)後後來轉為譫妄,2人(6.9%) 診斷改為創傷後壓力疾患。5名酒精或藥物濫用,有1人(20%) 於照會後產生譫妄,1人(20%) 併發適應性疾患。結論:較大灼傷面積、較久住院天數及火焰燒傷與較高照會率有關。在灼傷病房中,精神診斷會因急性病患病情變化而改變,精神科照會醫師應持續追蹤照會原因、診斷及照會結果。 |
英文摘要 | Objective: We assessed the factors related to psychiatric referral from a burn center. Methods: The records of patients hospitalized in a burn center of a medical center in southern Taiwan over a period of two years, from June 1992 through May 1994, were retrospectively analyzed. Severity and type of burn, days of hospitalization, reason for referral, and initial and follow-up diagnoses were analyzed. Results: During he study period, 523 patients were hospitalized in the burn center. Among these, 42 received weekly consulation with a psychiatric consultant. The psychiatric consultation rate was 8.03%, which is higher than the average of general hospital (0.72~1.7%). Patients with flame burn had a higher referral rate (13.0%) than those with scald burn (2.9%) (P<0.001). Patients referred for psychiatric consulation had larger areas of burn wound and more hospitalization days than those not referred (P<0.001). At initial consulation, there were 29 cases of adjustment disorder, six of delirium, five of substance abuse, and two of functional psychosis. The major reason for consultation in adjustment disorder was emotional problems; while that in other diagnoses was conduct problems. Among the 29 patients with adjustment symptoms, five (17.2%) developed delirium and two 6.9%) developed posttraumtic stress disorder, after the first consultation. Among the five patients with substance abuse, one (20%) developed delirium and one (20%) developed adjustment disorder after the first consultation. Conclusion: Greater extent of burn area, length of hospital stay, and flame burn are associateed with higher psychiatric referral rates. We recommend follow-up for reason of referral, psychiatric diagnosis, consulation results because of changeable medical and psychiatric conditions of acute burn patients in a burn center. |
本系統中英文摘要資訊取自各篇刊載內容。