Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montreal, Quebec, Canada.
Curr Opin Support Palliat Care. 2011 Jun;5(2):169-73. doi: 10.1097/SPC.0b013e3283462fdc.
Delirium is the most frequent neuropsychiatric disorder that affects the advanced cancer population who are receiving palliative care. There is limited evidence and much debate about the role of hydration in delirium management at the end of life. The purpose of this article is to review the literature on delirium management with regards to pharmacological management and hydration.
Pharmacological management is the first line of treatment for delirium, whereby antipsychotics are the medication of choice. However, they have not been approved by the United States Food and Drug Administration for delirium management as there is insufficient evidence supporting their use. Hydration is a believed to be a key component of delirium reversibility; yet there are conflicting results on its efficacy as an intervention for delirium management. As there are few studies of good methodological quality on the topic and large variations in practice, the effectiveness of hydration as an alternative management option for delirium is unclear.
More work is required to assess the role of hydration in delirium at the end of life. Given the lack of evidence-based research on hydration, more randomized clinical trials are needed to elucidate the effects of hydration as a delirium intervention.
谵妄是最常见的神经精神疾病，影响接受姑息治疗的晚期癌症患者。关于终末期患者的谵妄管理中，水化的作用，目前仅有有限的证据和大量的争论。本文旨在综述关于终末期患者的谵妄管理的文献，包括药物治疗和水化。
药物治疗是谵妄的一线治疗方法，其中抗精神病药是首选药物。然而，由于缺乏支持其使用的证据，它们并未被美国食品和药物管理局批准用于治疗谵妄。水化被认为是谵妄可逆性的关键组成部分；然而，关于其作为谵妄管理干预措施的疗效存在相互矛盾的结果。由于关于该主题的高质量研究较少，且实践中存在较大差异，因此水化作为替代治疗选择的有效性尚不清楚。
需要进一步研究以评估终末期患者的水化在谵妄中的作用。鉴于缺乏关于水化的循证研究，需要更多的随机临床试验来阐明水化作为谵妄干预的效果。
