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肝移植术后患者的精神科会诊。

Psychiatric consultation for post-liver-transplantation patients.

作者信息

Chiu Nien-Mu, Chen Chao-Long, Cheng Andrew T A

机构信息

Department of Psychiatry, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.

出版信息

Psychiatry Clin Neurosci. 2009 Aug;63(4):471-7. doi: 10.1111/j.1440-1819.2009.01987.x. Epub 2009 May 22.

Abstract

AIM

This report describes the clinical characteristics of referral inpatients who received liver transplantation and the surgeon's concordance with the psychiatric consultation.

METHODS

During a 4-year period, psychiatric consultation was arranged for 30 post-liver-transplantation inpatients at Kaohsiung Chang Gung Memorial Hospital. A psychiatrist assessed these patients and made psychiatric diagnoses according to the Diagnostic and Statistical Manual, 4th edition. The clinical data were routinely collected via modified MICRO-CARES software. At the end of the 4-year study period, all the medical records of these 30 inpatients were reviewed.

RESULTS

Psychiatric diagnosis was made in 70% of the patients (n = 21) in three major categories, including delirious state (n = 8), depressive disorder (n = 5), and anxiety/dyssomnia (n = 8). All these conditions were improved by psychiatric management. We found that the consultee's concordance with recommended drug prescriptions was high with antidepressants in depressive patients and low with antipsychotics in patients with delirium. Moreover, anxiolytics were frequently prescribed in post-transplant inpatients before psychiatric consultation.

CONCLUSION

These findings suggest that psychiatric consultation is beneficial to inpatients after liver transplantation, especially those with depression and delirium.

摘要

目的

本报告描述了接受肝移植的转诊住院患者的临床特征以及外科医生与精神科会诊的一致性。

方法

在4年期间,高雄长庚纪念医院为30例肝移植术后住院患者安排了精神科会诊。一名精神科医生对这些患者进行评估,并根据《精神疾病诊断与统计手册》第4版做出精神科诊断。临床数据通过改良的MICRO-CARES软件常规收集。在4年研究期结束时,对这30例住院患者的所有病历进行了回顾。

结果

70%的患者(n = 21)做出了精神科诊断,主要分为三大类,包括谵妄状态(n = 8)、抑郁症(n = 5)和焦虑/睡眠障碍(n = 8)。所有这些情况通过精神科治疗均得到改善。我们发现,在抑郁症患者中,会诊医生对推荐的抗抑郁药物处方的依从性较高,而在谵妄患者中,对抗精神病药物的依从性较低。此外,在精神科会诊前,移植后住院患者经常使用抗焦虑药。

结论

这些发现表明,精神科会诊对肝移植术后住院患者有益,尤其是对患有抑郁症和谵妄的患者。

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