美沙酮维持治疗外带服务的探索与实践

发布时间：2018-10-22 08:06

【摘要】：目的探索实施美沙酮维持治疗外带服务的适宜性及可操作性,为优化现有美沙酮维持治疗服务工作提供科学依据。方法招募符合条件的维持治疗患者,实施分级管理的美沙酮外带服务,持续尿检监测外带服务期间毒品使用情况,并研究分析其相关因素。结果 2015年3月至2016年4月,共计51名患者参与研究,男女性别比为2.64∶1,45岁者占51.0%(26人);小学及初中文化者占72.5%(37人);吸毒年限15年以上者占74.5%(38人);45例(88.2%)曾经有戒毒经历。外带服务期间尿检阳性率为1.24%(12/967),有12例(23.5%)因尿检阳性或不配合尿检而终止外带服务。管理水平较好的门诊中,研究对象退出美沙酮外带服务的比例相对较低(12.1%VS 44.4%,P0.001)。结论实施美沙酮外带服务时需要尽可能充分发挥其有利方面,并消除弊端的风险,使参与外带服务的患者能从中受益,并提高门诊维持治疗的质量和水平;在外带服务实施过程中,门诊需要增加心理咨询、行为矫治等综合干预措施以提升外带服务效果。
[Abstract]:Objective to explore the suitability and maneuverability of methadone maintenance therapy in order to provide scientific basis for optimizing the existing methadone maintenance treatment service. Methods to recruit suitably qualified patients for maintenance treatment, to carry out methadone extrinsic service with grading management, to monitor drug use during the period of continuous urine test and to analyze the related factors. Results from March 2015 to April 2016, a total of 51 patients participated in the study, with a sex ratio of 2.64: 1 to 45 years old (51.0%, 26 persons), primary school and junior middle school education (72.5%, 37 people), drug abuse for more than 15 years (74.5%, 38 people), and 45 cases (88.2%), who had drug abstinence experience. The positive rate of urine test was 1.24% (12 / 967) during the outerage service. 12 cases (23.5%) were terminated because the urine test was positive or did not cooperate with the urine test. In the outpatient clinics with good management, the proportion of subjects withdrawing from methadone extracellular service was relatively low (12.1%VS 44.4 / P0.001). Conclusion it is necessary to give full play to the advantages of methadone extracellular service and eliminate the risk of malpractice in order to benefit the patients who participate in the service and improve the quality and level of outpatient maintenance treatment. In order to improve the effect of outer-band service, comprehensive intervention measures such as psychological counseling and behavior correction should be added in the process of implementing outer-band service.
【作者单位】：武汉市疾病预防控制中心;武汉市精神卫生中心;
【分类号】：R749.64

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