Hepp U
Psychiatrische Poliklinik, UniversitätsSpital Zürich.
Praxis (Bern 1994). 2002 Mar 13;91(11):455-63. doi: 10.1024/0369-8394.91.11.455.
Delirium is a common psychiatric complication in somatically ill in-patients and is associated with increased morbidity and mortality, longer lengths of stay and higher cost of treatment. It remains often unrecognized and thus inadequately treated. The main risk factors, differential diagnosis, primary and secondary prevention, non-pharmacological interventions and pharmacological treatment are discussed. For the treatment of the non alcohol associated delirium, haloperidol remains the treatment of choice, whereas for the treatment of delirium related to alcohol withdrawal benzodiazepines and clomethiazole are recommended. Other treatment strategies, especially the use of newer atypical antipsychotic medications are outlined.
谵妄是躯体疾病住院患者常见的精神并发症,与发病率和死亡率增加、住院时间延长及治疗费用增高相关。它常常未被识别,因此治疗不充分。本文讨论了主要危险因素、鉴别诊断、一级和二级预防、非药物干预及药物治疗。对于非酒精相关性谵妄的治疗,氟哌啶醇仍是首选治疗药物,而对于酒精戒断相关的谵妄,推荐使用苯二氮䓬类药物和氯美噻唑。还概述了其他治疗策略,尤其是新型非典型抗精神病药物的使用。