Klinik und Poliklinik für Anästhesiologie und Operative Intensivmedizin, Rheinische Friedrich-Wilhelms Universität Bonn, Bonn, Germany.
Curr Opin Anaesthesiol. 2011 Dec;24(6):670-5. doi: 10.1097/ACO.0b013e32834c7b44.
Delirium is an acute, potentially life-threatening organ dysfunction with an incidence reported to range from 10-70% after surgery. Postoperative delirium was found to be associated with persisting cognitive deficits, increased physical dependence and institutionalization, and increased mortality. It is a condition particularly relevant to patients with increasing age.
This study summarizes recent works of the past 2 years, giving a brief overview as well as background information with regard to risk factors, impact on outcome parameters, mechanisms of pathophysiology, current use of hospital medication, and prevention and treatment strategies of postoperative delirium.
Delirium may have an impact on patients' outcomes beyond their stay in hospital, depending on preoperative comorbidities. Delirium can be devastating for activity of daily living, cognitive performance and survival. Predisposing factors should be recognized preoperatively; precipitating factors such as preoperative fasting, deep sedation and choice of psychotropic drugs, including sedatives, should be reconsidered. Regular structured delirium screening is the precondition for early detection and treatment. Treatment options include cognitive training programmes, anti-inflammatory measures and antipsychotic drugs.
谵妄是一种急性的、可能危及生命的器官功能障碍，术后发病率为 10%至 70%。术后谵妄与持续认知障碍、身体依赖性增加和住院治疗、死亡率增加有关。这种情况在年龄不断增长的患者中尤为相关。
本研究总结了过去 2 年的最新研究成果，简要概述了谵妄的风险因素、对预后参数的影响、发病机制、当前医院用药情况以及术后谵妄的预防和治疗策略。
术后谵妄的发生可能会影响患者的住院时间以外的预后，这取决于术前合并症的情况。谵妄会严重影响日常生活活动、认知表现和生存。应在术前识别易患因素；术前禁食、深度镇静和精神药物的选择（包括镇静剂）等诱发因素应重新考虑。定期进行结构化谵妄筛查是早期发现和治疗的前提。治疗选择包括认知训练计划、抗炎措施和抗精神病药物。
