重性精神疾病管理治疗模式的探讨

郭丽萍吉林省脑科医院精神病防治办公室，吉林四平　136000

重性精神疾病管理治疗模式的探讨

郭丽萍
吉林省脑科医院精神病防治办公室，吉林四平136000

目的探索重性精神病治疗随访管理新模式，建立防治机制和网络，提高治疗成功率，提高患者及其家属的生活质量，降低患者危险行为发生率，促进社会的稳定和和谐。方法选择四平市为试点，对辖区内常住居民进行精神疾病线索调查，根据线索信息入户调查，对符合ICD-10、CCMD-3标准确诊的重性精神疾病患者进行建档立卡管理，并录入全国重性精神疾病治疗管理网络系统，经危险行为评估，对有3级以上危险行为的贫困患者，给予免费服药管理、应急处置、免费住院治疗。结果线索调查获得有精神异常信息2 652条，初筛符合重性精神疾病的诊断标准者1737例，经评估有3级以上危险行为者352例。对244人次有危险行为或有严重药物副反应的重性精神疾病患者实施了应急处置，其中有108人次紧急住院，170人免费治疗。结论实施重性精神疾病管理治疗项目将有效减少症状复发，减少危险行为的发生，被管理者生存质量明显提高，有利于促进和谐社会的构建.

重性精神疾病；管理治疗；新型模式

［Abstract］Objective To explore the new model of treatment，follow-up and management of severe mental disease，build the prevention and control mechanism and network，improve the treatment success rate，improve the quality of life of patients and their families，reduce the incidence rate of dangerous behavior of patients and promote social stability and harmony.Methods Siping was selected as the pilot，the inhabitants within its jurisdiction were given mental disorder trace survey，the patients with severe mental disease meeting the ICD-10 and CCMD-3 standards were given establishing card for archives management according to the lead information household survey and input into nationwide severe mental disease treatment and management network system，after the evaluation of dangerous behavior，the poor patients with dangerous behavior above class 3 were given free medication administration，emergency handling and free hospitalization treatment.Results 2652 pieces of mental disorder information was obtained through trace survey，1737 cases met the diagnosis standards of severe mental disease after the preliminary screening，352 cases were with dangerous behavior above class 3 after evaluation，24 cases with dangerous behavior or serious drug side reaction were given emergency handling，among them，108 cases were hospitalized urgently and 170 cases were treated freely.Conclusion The implementation of severe mental disease management and treatment projects can effectively reduce the occurrence of symptoms，reduce the occurrence of dangerous behavior and obviously improve the survival quality of subordinates，which is conducive to the construction of harmonious society.

［Key words］Severe mental disease；Management and treatment；New model

重性精神疾病主要包括精神分裂症、双相情感性精神障碍、分裂情感性精神障碍、偏执性精神病、癫痫所致精神障碍、精神发育迟滞伴发精神病6种疾病［1］，在人群中具有一定的患病比例。在我国，重性精神疾病的治疗长期以医院为主，孤岛式的服务不能满足重性精神疾病需要的全程管理治疗，也无法满足患者多样化的需求。……