救命救急センターにおける刺創・墜落外傷自殺企図入院患者の臨床的特徴

Clinical Characteristics of Suicidal Inpatients with Injuries from Cutting and Leaping Treated at Emergency Medical Care Centers

抄録　致死性が高い自殺企図手段を選択する者は精神症状も重篤なことが多い。救命救急センターに搬送された自殺企図患者を，その手段によって刺創と墜落外傷に分け，臨床的特徴を比較検討した。年齢は刺創群より墜落群において有意に低く，入院期間は刺創群より墜落群において有意に長く，転院は刺創群より墜落群で有意に多かった。精神科診断は両群ともF2(統合失調症，統合失調症型障害および妄想性障害)，F3(気分障害)の占める割合が高かった。致死的になりやすい自殺手段をとった患者への対応において，精神症状の評価や精神科治療は特に重要である。墜落外傷に対しては，精神科，整形外科治療，理学療法などの可能な施設，精神科医との連携の工夫が必要と考えられた。

　Patients who selected a method with a high success rate in their attempt to commit suicide often suffer from severe psychological symptoms. The patients who had attempted to commit suicide were divided in accordance with the method they used to commit suicide, namely, cutting(cut-injury group)and leaping from a height(leaping group). The clinical characteristics of the patients in these two groups were compared. The patients in the leaping group were statistically significantly younger than the patients in the cut-injury group. The duration of hospitalization of the patients in the leaping group was statistically significantly longer than that of the patients in the cut-injury group. The percentage of patients in the leaping group who were transferred to another hospital was higher than that of the patients in the cut-injury group. For both groups, the percentages of patients classified as having F2 disorders(schizophrenia, schizotypal and delusional disorders)and F3 disorders(mood disorder)were high. For the treatment and recovery of patients who attempted to commit suicide using a method highly likely to lead to death, evaluation and treatment of their psychological symptoms are especially important. To treat injuries caused by leaping, good cooperation between emergency medical care centers and medical institutions with psychiatrists, orthopedists, and physical therapists is necessary.