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低剂量曲唑酮治疗接受专科姑息治疗的癌症患者谵妄:一项多中心前瞻性研究。

Low-Dose Trazodone for Delirium in Patients with Cancer Who Received Specialist Palliative Care: A Multicenter Prospective Study.

机构信息

Department of Palliative Care, Senri-Chuo Hospital, Toyonaka, Japan.

Department of Neuropsychiatry, Okayama University Hospital, Okayama, Japan.

出版信息

J Palliat Med. 2021 Jun;24(6):914-918. doi: 10.1089/jpm.2020.0610. Epub 2021 Feb 11.

Abstract

Clinical usefulness of trazodone for delirium in patients receiving palliative care is unclear. To examine the safety and effectiveness of trazodone for delirium. A secondary analysis of a multicenter prospective observational study. The setting involves nine psycho-oncology consultation services and 14 inpatient palliative care units in Japan. The measurement involves the Delirium Rating Scale (DRS) Revised-98 for effectiveness and the CTCAE (Common Terminology Criteria for Adverse Events) version 4 for safety assessments. Thirty-eight patients enrolled the study. Mean age was 75 years. After three-day observation, the DRS total score (11.6 ± 5.3 to 8.7 ± 6.5 [difference -2.9, 95% confidence interval -5.3 to -0.5,  = 0.02]); sleep-wake cycle disturbance ( = 0.047), lability of affect ( < 0.001), and motor agitation subscales ( < 0.001) were significantly decreased. The most frequent adverse event was somnolence ( = 9). Low-dose trazodone treatment was generally safe and may be effective in reducing delirium severity.

摘要

在接受姑息治疗的患者中,曲唑酮治疗谵妄的临床效果尚不清楚。为了考察曲唑酮治疗谵妄的安全性和有效性,我们对一项多中心前瞻性观察研究进行了二次分析。该研究的地点涉及日本的 9 个心理肿瘤学咨询服务机构和 14 个住院姑息治疗病房。研究采用修订版 98 项谵妄评定量表(DRS-R98)评估疗效,采用 CTCAE(不良事件通用术语标准)第 4 版评估安全性。共纳入 38 例患者,平均年龄为 75 岁。经过 3 天的观察,DRS 总分(从 11.6±5.3 降至 8.7±6.5 [差值-2.9,95%置信区间-5.3 至-0.5,=0.02])、睡眠-觉醒周期紊乱(=0.047)、情感不稳定性(<0.001)和运动激越分项(<0.001)均显著降低。最常见的不良事件是嗜睡(=9)。曲唑酮低剂量治疗通常是安全的,可能有助于降低谵妄严重程度。

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