Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts (M.L.M.).
Ann Intern Med. 2020 Oct 6;173(7):ITC49-ITC64. doi: 10.7326/AITC202010060.
Delirium is an acute confusional state that is common and costly and is associated with significant functional decline and distress. It is the manifestation of acute encephalopathy and is variably called , , or . All patients are at risk for delirium, although those with more vulnerabilities (such as advanced age, exposures to other stressors like infection, and certain medications) are at higher risk. The pathophysiologic cause of delirium is not well understood. It is important to recognize patients at risk for and those with delirium and to immediately identify and treat factors contributing to it. There is no single intervention or medication to treat delirium, making it challenging to manage. Therefore, risk mitigation and prompt treatment rely on a sophisticated strategy to address the contributing factors. Delirium may be prevented or attenuated when multimodal strategies are used, thereby improving patient outcomes.
谵妄是一种常见且代价高昂的急性意识混乱状态，与显著的功能下降和痛苦相关。它是急性脑病的表现形式，并有多种不同的称呼，如、或。所有患者都有发生谵妄的风险，尽管那些具有更多脆弱性的患者（如高龄、感染等其他应激源暴露以及某些药物）风险更高。谵妄的病理生理原因尚不清楚。识别有发生谵妄风险的患者和已经发生谵妄的患者，并立即识别和治疗导致谵妄的因素非常重要。没有单一的干预或药物可以治疗谵妄，因此管理起来具有挑战性。因此，风险缓解和及时治疗依赖于一种复杂的策略来解决促成因素。当使用多模式策略时，谵妄可以预防或减轻，从而改善患者的预后。
