泰国红十字会朱拉隆功国王纪念医院电休克治疗的使用情况及精神科住院患者的住院时长

The use of electroconvulsive therapy and the length of stay of psychiatric inpatients at King Chulalongkorn Memorial Hospital, Thai Red Cross Society.

作者信息

Lalitanatpong Decha

机构信息

Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.

出版信息

J Med Assoc Thai. 2005 Sep;88 Suppl 4:S142-8.

PMID:16623019

Abstract

BACKGROUND

Electroconvulsive therapy (ECT) is the effective treatment in psychiatric patients. However, the controversies about the risk and benefit limit the use of this procedure. Some efficacies of ECT may be interesting to use in hospitalized patients such as rapid onset, risk reduction but it may increase the length of stay (LOS) in previous study.

OBJECTIVES

To study the use of ECT in hospitalized psychiatric patients in the aspect of indication , diagnosis and the length of stay.

MATERIAL AND METHOD

From August to September 2004, all 51 cases of psychiatric inpatient medical records were studied. The top five of diagnosis were schizophrenia (49%), bipolar disorder (23.5%), acute psychosis (7.8%), depressive disorder (5.9%) and dementia (5.9%). ECT was performed in 22 cases (43.1%).

RESULTS

The average length of stay was 21.5 +/- 14.5 days. The mean LOS of the ECT group 25.9 +/- 15.8 days was not quite longer compared with 17.8 +/- 12.7 days of the Non ECT group comparison between the ECT group (64%) and the non ECT group (36%) of schizophrenia, the LOS of each group was 27.3 +/- 16.7 and 16.9 +/- 8.8 days which was also not significant. LOS of ECT of the bipolar group (20%) and the non ECT bipolar group (80%) was 10.5 +/- 4.9 and 23.0 +/- 18.3 days which was not statistically significant (p = 0.39). There were 3 major indications for ECT such as a severe violence case, suicidal case, refractory case with the mean LOS of 19.9 +/- 10.9, 17.5 +/- 12.8, 43.3 +/- 21.2 and 31.7 +/- 8.3 days subsequently. The patients who had the refractory indication had a longer length of stay than other indications.

CONCLUSION

Overall average length of stay was not longer in the ECT group. The ECT group had a longer length of stay than the non ECT group in the refractory treatment case only. ECT can be used in a psychiatric ward with the efficacy of its indication without prolonged length of stay.

摘要

背景

电休克治疗（ECT）是治疗精神疾病患者的有效方法。然而，关于其风险和益处的争议限制了该治疗方法的使用。ECT的一些疗效，如起效快、风险降低等，可能对住院患者有益，但在先前的研究中它可能会增加住院时间（LOS）。

目的

从适应证、诊断及住院时间方面研究ECT在住院精神疾病患者中的应用。

材料与方法

研究2004年8月至9月期间51例精神科住院患者的病历。诊断排名前五位的分别是精神分裂症（49%）、双相情感障碍（23.5%）、急性精神病（7.8%）、抑郁症（5.9%）和痴呆症（5.9%）。22例（43.1%）患者接受了ECT治疗。

结果

平均住院时间为21.5±14.5天。ECT组的平均住院时间为25.9±15.8天，与非ECT组的17.8±12.7天相比，延长并不显著。在精神分裂症患者的ECT组（64%）和非ECT组（36%）中，每组的住院时间分别为27.3±16.7天和16.9±8.8天，差异也不显著。双相情感障碍组中ECT组（20%）和非ECT组（80%）的住院时间分别为10.5±4.9天和23.0±18.3天，差异无统计学意义（p = 0.39）。ECT有3个主要适应证，如严重暴力案件、自杀案件、难治性病例，其平均住院时间分别为19.9±10.9天、17.5±12.8天、43.3±21.2天和31.7±8.3天。有难治性适应证的患者住院时间比其他适应证的患者更长。