精神科入院中に深部静脈血栓症，肺血栓塞栓に罹患した症例の臨床的検討

Clinical Features of Psychiatric Inpatients Suffering from Deep Vein Thrombosis or Pulmonary Thromboembolism

抄録

　精神科入院中に深部静脈血栓症，肺血栓塞栓症に罹患した7症例の臨床特徴を検討した。6症例では静脈血栓症に先行して何らかの身体疾患(肺炎，胃潰瘍など)がみられた。身体疾患や精神症状，治療方法などに起因する種々の要因のために，すべての症例で活動性が低下あるいは制限されていた。すべての症例で経口摂取が十分できておらず，5症例は軽度～中等度の脱水状態を呈していた。5症例で向精神薬が投与されていたが，投与量は少なく，関与が推測される薬物は特定できなかった。精神科領域でも静脈系の血栓症発症の可能性を念頭に置き，身体疾患の精査，脱水や長期臥床の予防，状態に応じた適切な治療方法や環境の選択などを行うことが重要である。

　We investigated the clinical features of seven psychiatric inpatients suffering from deep vein thrombosis or pulmonary thromboembolism. Among these subjects, 6 patients were suffering from physical complications, for example pneumonia or gastric ulcer, which preceded venous thrombosis. The activity of all the patients was either immobilized or restricted because of various factors resulting from some of the physical complications, mental conditions, or psychiatric treatment methods. None of the patients had performed sufficient oral ingestion, and 5 patients had experienced slight or moderate dehydration. Although many of the cases had been medicated with psychotropic drugs, dosage was comparatively small, and it was difficult to identify the drug causing venous thrombosis. In the psychiatric domain, it is important to consider in advance the possibility of venous thrombosis, to examine the physical complications which cause venous thrombosis, to prevent dehydration or immobility, and to select suitable medical treatment methods and environment.