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社区应用抗精神病药长效针剂治疗精神分裂症专家共识

中华医学会精神医学分会精神分裂症协作组，中华医学会全科医学分会 扫描二维码
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【摘要】 精神分裂症是一种慢性、高复发性和高致残性的精神病性障碍，提高患者治疗依从性、预防复发是精
神分裂症治疗的关键，也是决定患者预后和社会功能改善程度的核心因素。抗精神病药长效针剂（简称长效针剂）作
为精神分裂症治疗、预防复发的重要手段，被国内外指南 / 共识推荐为精神分裂症全病程治疗的方式之一。同时，社
区作为精神分裂症康复的重要环境场所，近年来陆续开展了一系列社区管理模式的探索。目前，国内多个管理政策及
文件强调在社区精神分裂症管理中应用长效针剂，但是社区医生对长效针剂的知识和应用技能不足，从一定程度上影
响了长效针剂在社区的应用，成为患者全面康复的瓶颈之一。在中华医学会精神医学分会精神分裂症协作组的组织下，
联合中华医学会全科医学分会，由 13 位精神科及全科医学专家组成本共识专家组，基于循证医学证据、国内外指南
与专家共识、专家经验、我国社区的特征，解决社区长效针剂使用中面临的医学相关问题，以期提高精神分裂症患者
用药依从性，改善患者预后。
【关键词】 精神分裂症；抗精神病药；抗精神病药长效针剂；社区卫生服务
【中图分类号】 R 749.3 【文献标识码】 A DOI：10.12114/j.issn.1007-9572.2022.0537
中华医学会精神医学分会精神分裂症协作组，中华医学会全科医学分会 . 社区应用抗精神病药长效针剂治疗精神
分裂症专家共识［J］. 中国全科医学，2022，25（29）：3587-3602. ［www.chinagp.net］
Chinese Schizophrenia Coordination Group，Chinese Society of Psychiatry，Chinese Society of General Practice. Expert
consensus on long-acting injectable antipsychotic in the treatment of schizophrenia in community［J］. Chinese General
Practice，2022，25（29）：3587-3602.

Expert Consensus on Long-acting Injectable Antipsychotic in the Treatment of Schizophrenia in Community Chinese
Schizophrenia Coordination Group，Chinese Society of Psychiatry，Chinese Society of General Practice
*
Corresponding author：SI Tianmei，Professor；E-mail：si.tian-mei@163.com
【Abstract】 Schizophrenia is a chronic，recurrent and disabling psychotic disorder. Enhancing patient adherence and
preventing recurrence are the key factors of treating schizophrenia，and the core determinants of prognosis and social functional
recovery of these patients. Recommended by guidelines/consensuses as one treatment for schizophrenia，long-acting injectable
（LAI） antipsychotics have been an important intervention for treating schizophrenia and for preventing its recurrence. At
the same time，as community settings are important sites for the rehabilitation of schizophrenia，considerable efforts have
been made to explore models of community-based management of schizophrenia. Currently，the use of LAI antipsychotics in
community-based management of schizophrenia has been highlighted in multiple policies and documents of China，but its
application is negatively influenced partially by community physicians' insufficient understanding and application skills regarding
LAI antipsychotics，which has become a bottleneck that hinders the comprehensive rehabilitation of schizophrenics. In view of
this，a consensus was developed based on clinical evidence，previous guidelines and consensuses，expert individual practice
and features of community settings in China，by a group of 13 experts，including psychiatrists from the Chinese Schizophrenia
Coordination Group，Chinese Society of Psychiatry，and general medicine experts from the Chinese Society of General Practice.
This consensus will significantly contribute to the solving of problems in the use of LAI antipsychotics for community-based
management of schizophrenia，and the improvement of patient adherence and prognosis.
【Key words】 Schizophrenia；Antipsychoric agents；Long-acting injectable；Community health services

1 概述 青壮年时期，呈反复波动的病程。10%~15% 的患者
1.1 精神分裂症的危害及挑战 精神分裂症是一种 经历首次精神分裂症后痊愈，更高比例的患者则可
慢性、复发性、高致残性的精神病性障碍，常起病于 能进入迁延加重的状态 ［1-3］ 。复发不仅是精神症状
的再次出现，还会加剧疾病进行性进展，降低患者
*
通信作者：司天梅，教授；E-mail：si.tian-mei@163.com
本文数字出版日期：2022-07-29 对药物治疗的反应，影响患者功能水平和生活质量，