Macleod A D
Nurse Maude Hospice and Brain Injury Rehabilitation Service, Burwood Hospital, Christchurch, New Zealand.
Palliat Support Care. 2006 Sep;4(3):305-12. doi: 10.1017/s147895150606038x.
Delirium is a common syndrome complicating terminal illness. It is underrecognized partly because it is a difficult clinical concept. Consciousness, awareness, alertness, arousal, awakeness, vigilance, and attention are some of the terms used to describe the deficits occurring in delirium. Though interconnected, they are often loosely defined. Alertness is the primary impairment, and attentional deficits are objective clinical indices of the cognitive impairments of delirium. Simple bedside assessments of delirium are considered. The "deliriant" threshold and the symptomatic fluctuations of delirium are important concepts in the understanding of delirium. Jackson's conceptualization of the nervous system is relevant to delirium. Raising the deliriant threshold by multicomponent interventions is the intent of the palliative management of terminal delirium.
谵妄是一种使终末期疾病复杂化的常见综合征。它未得到充分认识，部分原因是它是一个难以理解的临床概念。意识、觉知、警觉、觉醒、清醒、警惕和注意力是用于描述谵妄中出现的缺陷的一些术语。尽管它们相互关联，但往往定义不明确。警觉性是主要损害，注意力缺陷是谵妄认知障碍的客观临床指标。文中考虑了对谵妄进行简单的床边评估。“致谵妄”阈值和谵妄的症状波动是理解谵妄的重要概念。杰克逊对神经系统的概念化与谵妄相关。通过多组分干预提高致谵妄阈值是终末期谵妄姑息治疗的目的。
