医院幻觉症--从何处寻找老年病人谵妄综合征的病因以及应采取的治疗措施

Karolina Tomczyk, Karolina Jurasz, Natalia Chojnacka, Jakub Klarycki, Dominika Podgórska, Radosław Cymer, Ewa Rzeska, Miłosz Sanecki
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引用次数: 0

摘要

谵妄综合征是老年患者的一个严重问题,但往往被低估。这种急性病症的准确诊断率远远低于实际诊断率。这通常是由于将其症状归咎于潜在疾病所致。谵妄综合征会导致患者知觉障碍,损害其功能,威胁患者的健康甚至生命。谵妄发病的病理生理学尚不十分清楚,影响其发展的因素很多。其中既有与患者直接相关的因素(易患因素),也有诱发因素。老年病人由于身体机能储备耗尽,发生谵妄的风险远高于年轻病人。即使是很小的负面刺激,人体各系统的平衡也会受到干扰。重要的是要密切观察病人,充分收集病人的基本健康状况和病情变化的病史。完善的体格检查和影像诊断至关重要。管理神志不清的患者没有通用的方案。重要的是要采取个性化的方法,迅速找到病因并尝试治疗。我们可以使用常用的诊断谵妄综合征的量表和指南,如 ICD-10、DSM-5 或 CAM,使准确诊断更加容易。事实证明,在非药物预防管理的帮助下,我们可以大大减少老年患者在谵妄过程中出现的意识障碍。在病情严重的情况下,药物治疗会对我们有所帮助。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Hospital Hallucinosis - where to look for the cause of the delirious syndrome in a geriatric patient and what management to implement
Delirium syndrome is a serious, and often underestimated, problem arising in elderly patients. The number of accurate diagnoses of this acute condition is significantly lower than actuall present. This is often due to the attribution of its symptoms to the underlying disease. Delirium syndrome, by leading to perceptual disturbances in the patient, impairs his functioning and threatens health and even life of a patient. The pathophysiology of the onset of delirium is not well understood, with many factors influencing its development. Those directly related to the patient (predisposing), as well as triggering factors. In geriatric patients, the risk of developing delirium is much higher than in younger patients due to the depletion of the body's functional reserves. Homeostasis of the body's systems is disturbed even with small negative stimuli. It is important to closely observe the patient, taking a well-gathered history of the patient's baseline health status and the changes that have occurred in the patient's condition. A well-conducted physical examination and diagnostic imaging is essential. There is no universal scheme for managing a patient who is delirious. It is important to take an personalized approach and quickly find the cause and try to treat it. We can use commonly available scales and guidelines for diagnosing the delirious syndrome, such as ICD-10, DSM-5 or CAM, to make the accurate diagnosis easier. It has been shown that with the help of non-pharmacological preventive management, we can significantly reduce the number of consciousness disorders that appear in elderly patients under the course of delirium. In severe cases, pharmacotherapy comes to our aid.
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