Stoffels J M J, van Munster B C, Muller M
Amsterdam UMC, locatie VUmc, afd. Interne-ouderengeneeskunde, Amsterdam.
Contact: J.M.J. Stoffels (
Ned Tijdschr Geneeskd. 2020 Nov 23;164:D4953.
In delirium, there is an acute change of consciousness with fluctuations in attention, cognition and perception. Delirium can be provoked by medical conditions, or the use or withdrawal of drugs. Risk factors include older age and cognitive impairment. Delirium is associated with many complications, represents a significant emotional burden for the patient and caretakers, increases length of stay in the hospital, and causes higher health care costs. Non-pharmacological measurements can sometimes prevent delirium, and are essential for its treatment with proven effectiveness. Antipsychotics should be administered only as an exception, not as a rule. Antipsychotics may be of use when the patient puts himself or others in danger, or when he suffers substantially from hallucinations.
在谵妄状态下,意识会发生急性改变,注意力、认知和感知出现波动。谵妄可能由躯体疾病、药物使用或戒断引发。危险因素包括高龄和认知障碍。谵妄与许多并发症相关,给患者及其照料者带来沉重的情感负担,增加住院时间,并导致更高的医疗费用。非药物措施有时可预防谵妄,且对其治疗至关重要且已证实有效。抗精神病药物应仅在例外情况下使用,而非常规使用。当患者对自己或他人构成危险,或严重受幻觉折磨时,抗精神病药物可能会有用。