CAJ | 학술논문

目的：探讨综合性医院精神科会诊中的谵妄与精神病专科医院中的谵妄的临床特点。方法：对综合性医院中精神科会诊中的28例谵妄患者（会诊组）与同期在精神病院的24例患者（非会诊组）的临床资料进行对照分析，并使用谵妄评分量表中文修订版（ CAM-CR）测评。结果：会诊组中的谵妄患者年龄偏大，病因复杂，内科疾病以呼吸系统感染、脑卒中、心血管疾患多见，外科疾病以脑外伤、手术后、骨折多见，其中多系统疾病引起谵妄的几率最高，CAM-CR 精神运动性抑制因子分显著高于非会诊组；非会诊组相对年龄偏小，病因简单，以精神活性物质依赖戒断、老年痴呆、抗精神病药应用不当多见， CAM-CR 总分及意识水平的改变、知觉障碍、精神运动性兴奋因子分均显著高于会诊组。结论：综合性医院中的谵妄患者年龄大，病因症状复杂，误诊率高，预后差。会诊联络亟待加强。
목적：탐토종합성의원정신과회진중적섬망여정신병전과의원중적섬망적림상특점。방법：대종합성의원중정신과회진중적28례섬망환자（회진조）여동기재정신병원적24례환자（비회진조）적림상자료진행대조분석，병사용섬망평분량표중문수정판（ CAM-CR）측평。결과：회진조중적섬망환자년령편대，병인복잡，내과질병이호흡계통감염、뇌졸중、심혈관질환다견，외과질병이뇌외상、수술후、골절다견，기중다계통질병인기섬망적궤솔최고，CAM-CR 정신운동성억제인자분현저고우비회진조；비회진조상대년령편소，병인간단，이정신활성물질의뢰계단、노년치태、항정신병약응용불당다견， CAM-CR 총분급의식수평적개변、지각장애、정신운동성흥강인자분균현저고우회진조。결론：종합성의원중적섬망환자년령대，병인증상복잡，오진솔고，예후차。회진련락극대가강。
Objective:To explore the clinical characteristics of delirium patients referred to consultation-liaison psychiatry in general hospitals,as well as those in psychiatric hospitals. Method:The clinical data of 28 delirium patients referred to consultation-liaison psychiatry in general hospitals(consulation-liaison group) and 24 delirium patients in psychiatric hospitals(non-consulation-liaison group)admitted were included for a contrast analysis. They were all evaluated by the Chinese revision of confusion assessment method(CAM-CR). Results:Delirium patients in the consultation-liaison group were with elder age and complex etiology. Medi-cine diseases they suffering from were mainly in respiratory tract infections,brain stroke and cardiovascular dis-eases,while the surgical diseases were mainly in cerebral trauma,post-operation and fractures. Among them, multi-system diseases had the highest probability of causing delirium. The psychomotor retardation score in CAM-CR was significantly higher than the non-consultation-liaison group. However,delirium patients in non-consulation-liaison group were with younger age and simple etiology. Their diseases were mainly caused by with-drawing from psychoactive substances,senile dementia and improper application of antipsychotics. The total score,change in the level of consciousness,perceptual disturbance and psychomotor excitation scores in CAM-CR were all significantly higher than the consultation-liaison group. Conclusion:Elder age,complex etiology and symptoms,high misdiagnosis rate and poor prognosis are among the main features in delirium patients in general hospitals,the consultation liaison needs to be strengthened.