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重症监护病房中的精神科与姑息治疗

Psychiatric and Palliative Care in the Intensive Care Unit.

作者信息

Harman Stephanie M

机构信息

Department of Medicine, Stanford University School of Medicine, 1265 Welch Road, MC 5475, Stanford, CA 94305, USA.

出版信息

Crit Care Clin. 2017 Jul;33(3):735-743. doi: 10.1016/j.ccc.2017.03.010. Epub 2017 May 5.

Abstract

Palliative care is specialized medical care focused on patients with serious illness and their families. In the intensive care unit (ICU), palliative care encompasses core skills to support patients and their families throughout their ICU course and post-ICU stays. Psychiatric symptoms are common among patients approaching the end of life and require particular attention in the setting of sedating medications, typically used when patients require ventilators and other life-sustaining treatments. For patients with preexisting severe mental illness who have a concurrent serious medical illness, a palliative psychiatric approach can address complex symptom management and support ethical and value-based shared decision making.

摘要

姑息治疗是针对重病患者及其家属的专业医疗护理。在重症监护病房(ICU),姑息治疗涵盖了一系列核心技能,以在患者的ICU治疗过程及ICU后的住院期间为患者及其家属提供支持。临终患者中精神症状很常见,在使用镇静药物的情况下需要特别关注,镇静药物通常在患者需要呼吸机和其他维持生命的治疗时使用。对于患有严重精神疾病且同时患有严重躯体疾病的患者,姑息性精神科方法可以解决复杂的症状管理问题,并支持基于伦理和价值观的共同决策。

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