心脏外科住院患者围手术期精神科会诊分析

摘要

目的:探讨心脏外科住院患者围手术期精神科会诊的特点. 方法:回顾性分析2010～2015年间156例申请精神科会诊的心脏外科围手术期住院患者的会诊情况. 结果:2010年及2014年会诊率分别为0.04％及0.69％;主要会诊目的是处理兴奋躁动(53.8％)、焦虑和/或抑郁情绪(25.0％),主要会诊诊断分别为谵妄(58.3％)及焦虑和/或抑郁状态(21.8％);请求会诊的心脏外科医生与精神科医生在焦虑和/或抑郁状态的诊断上一致率较高(88.2％);89.7％的会诊病例被建议使用精神类药物治疗. 结论:心脏外科对精神科会诊需求增大,术前焦虑抑郁评估及干预有待加强,精神科除了提供会诊服务外,还应该加强联络方面工作.%Objective:To investigate the characteristics of the consultation-liaison service to peroperative cardiac surgery hospitalized patients.Method:The data of psychiatric consultation during perioperative period in 156 inpatients from department of cardiac surgery from 2010 to 2015 were retrospectively analyzed.Results:The psychiatry consultation rate was 0.04％ in 2010,while it was 0.69％ in 2014.The main reasons for referral were to deal with the excitement,restlessness (53.8％) and anxious and/or depressed mood (25.0％).The main consultation diagnoses were delirium (58.3％) and anxious and/or depressed state (21.8％).The concordance rate of diagnosis of anxious and/or depressed state between the cardiac surgeon who asked for a consultation and psychiatrist was 88.2％.The 89.7％ consultative cases were recommended to use psychotropic drugs.Conclusion:The need for consultation-liaison psychiatry service in cardiac surgery is increasing,and the preoperative anxiety and depression evaluation and intervention should be strengthened.Besides,the psychiatric department should strengthen the liaison work in addition to providing consultation service.