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急性护理环境中的谵妄:特征、诊断与治疗

Delirium in the acute care setting: characteristics, diagnosis and treatment.

作者信息

Maldonado José R

机构信息

Department of Psychiatry, Stanford University School of Medicine, Stanford, CA 94305, USA.

出版信息

Crit Care Clin. 2008 Oct;24(4):657-722, vii. doi: 10.1016/j.ccc.2008.05.008.

Abstract

Delirium is a neurobehavioral syndrome caused by the transient disruption of normal neuronal activity secondary to systemic disturbances. It is also the most common psychiatric syndrome found in the general hospital setting, its prevalence surpassing better known psychiatric disorders. This article reviews the published literature on delirium and addresses the epidemiology, known etiologic factors, presentation and characteristics of delirium, while emphasizing what is known about treatment strategies and prevention. Given increasing evidence that delirium is not always reversible and the many sequelae associated with its development, physicians must do everything possible to prevent its occurrence or shorten its duration, by recognizing its symptoms early, correcting underlying contributing causes, and using treatment strategies proven to help recover functional status.

摘要

谵妄是一种神经行为综合征,由继发于全身紊乱的正常神经元活动短暂中断引起。它也是综合医院环境中最常见的精神综合征,其患病率超过了更知名的精神障碍。本文回顾了关于谵妄的已发表文献,并探讨了谵妄的流行病学、已知病因、表现和特征,同时强调了关于治疗策略和预防的已知内容。鉴于越来越多的证据表明谵妄并非总是可逆的,且其发展会带来许多后遗症,医生必须尽一切可能预防其发生或缩短其持续时间,方法是尽早识别其症状、纠正潜在的促成因素,并采用经证实有助于恢复功能状态的治疗策略。

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