摘要
目的探讨老年期谵妄的临床特征及预后状况，为临床干预提供依据。方法将61例老年期谵妄患者按年龄不同分为两组，年龄〈75岁共33例，设为A组；≥75岁共28例，设为B组；对两组的一般资料、躯体疾病状况、诱发谵妄危险因素、谵妄评分量表评分、临床疗效等资料以及出院后6月-1a的随访结果进行对比分析。结果两组90．20％为急性起病，一般资料差异无显著性；A组脑梗塞及老年期痴呆发病率显著低于B组（x^2=5．60、17．87，P〈0．05或0．01）；有精神刺激、白细胞增高、低氧血症、胆红素增高等诱发谵妄危险因素均显著高于B组（P〈O．05）；谵妄评分量表总分及急性起病、意识水平的改变、知觉障碍、精神运动性兴奋因子分均显著高于B组（P〈O．01）；精神运动性抑制因子分显著低于B组（P〈O．01）；两组总有效率，住院死亡率差异均无显著性（P〉0．05）；A组出院1a内死亡率为6．25％，B组为29．63％，A组显著低于B组（P〈O．01）。结论老年期谵妄发病急，有波动病程，发病以意识障碍为主，及时诊断与治疗预后相对较好；高龄老年期谵妄抑制症状较多，出院后易罹患痴呆或加重原痴呆症状、1a内死亡率较高，因此，对出院的老年期谵妄患者要密切随访，及时治疗躯体疾病，以改善老年期谵妄的预后。
Objective To explore the clinical features and prognosis for senile delirium in order to provide basis for clinical interventon. Methods Sixty-one senile delirium patients were divided into group A （〈 75, n=33） and B （≥75, n=28） according to age. Such data were contrastively analyzed as general information, status of somatic diseases, risk factors inducing delirium, score of the Dilirium Rating Scale （DRS） and clinical efficacy as well as 6-month follow-up results after discharge. Results 90.20%of 61 patients were acute onset, their clinical information had no significant difference; incidences of cerebral infarction and senile dementia were significantly lower in group A than B （x^2= 5. 60,17.87, P〈0.05 or 0.01）, causative factors such as mental stimulation, increased leukocyte, hypoxemia and increased biliru- bin significantly higher （P〈0.01）, the totalacute onset, changes of consciousness, perceptual disorders and psychomotor excitement score significantly higher （P〈0.01）, and psychomotor inhibition score significantly lower （P〈0.01）. There were no significant differences in total effective and hospital mortality rates （P〉0.05）. Mortality rates within one year after disehage were significantly lower in the group A than B （6.25 % vs. 29.63 %, P〈0.01）. Conclusion Senile delirium characterized by acute onset,fluctuating course of disease, and timely diagnosis and treatment have a better prognosis; senile ttelirium has more depression symptoms, suffers from dementia or aggravates previous dementia symptoms easily and death rate is higher within one year, so dsicharged senile delirium patients are followed up closely and somatic diseases treated timely in order to improve prognosis of senile delirium.
出处
《临床心身疾病杂志》
CAS
2011年第3期211-213,共3页
Journal of Clinical Psychosomatic Diseases
