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[谵妄的非药物治疗和药物治疗]

[Non-pharmacological and pharmacological therapy of delirium].

作者信息

Reith Sebastian

出版信息

Dtsch Med Wochenschr. 2019 Nov;144(23):1629-1635. doi: 10.1055/a-0826-2780. Epub 2019 Nov 21.

Abstract

The therapeutic management of delirium is based on two major columns. The cornerstone of therapy is the non-pharmacological intervention using a multifactorial approach including early mobilization, reorientation, improvement of cerebral and cognitive activity and the consequent establishment of adequate wake-/sleep cycles. Evidence for specific pharmacotherapy in delirium is currently rare, for both delirium prophylaxis as well as for definitive therapy of clinically apparent delirium. However, in clinical routine several substances are commonly used for the management of delirium particularly in a symptom-oriented choice. Moreover, regarding delirium prophylaxis the choice of sedativum has an important clinical impact on the incidence of delirium.

摘要

谵妄的治疗管理基于两大支柱。治疗的基石是非药物干预,采用多因素方法,包括早期活动、重新定向、改善脑和认知活动以及随之建立适当的觉醒/睡眠周期。目前,无论是谵妄预防还是明显临床谵妄的确切治疗,特定药物治疗的证据都很少。然而,在临床实践中,几种药物常用于谵妄的管理,特别是在以症状为导向的选择中。此外,关于谵妄预防,镇静剂的选择对谵妄的发生率有重要的临床影响。

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