摘要
谵妄在重症监护室(ICU)的发生率很高,其给危重患者的预后带来一系列不良影响。由于谵妄的病理生理学机制尚未完全明确给治疗带来了困难,所以预防ICU谵妄变得尤为重要。目前,预防ICU谵妄主要以药物性和非药物性为主,虽然药物性预防仍需要大样本研究,但部分非药物性干预效果已得到认可。其中,谵妄的评估和管理至关重要,尤其是对一些可控的危险因素和医疗行为的干预,如优化ICU机械通气程序、镇静策略和调控环境因素等。然而,危重患者疾病的复杂性和特殊性使预防性研究仍进展缓慢。未来,需要更大样本的试验来进一步证实预防ICU谵妄措施的效果以及阐明其病理生理学机制。
The incidence of delirium in the intensive care unit （ICU） is very high, which brings a series of adverse effects to the prognosis of critical patients. The pathophysiology of delirium is not completely understood, bringing difficulties to the treatment. Therefore, the prevention is crucial. At present, the prevention of ICU delirium mainly includes pharmaco- logical therapies and non-pharmacological therapies. Pharmacological therapies still need large sample studies, however, some of the non-pharmacological therapies are deemed effective. The assessment and management of delirium is important, especially interventions to some of the controllable risk factors and medical behavior, such as optimizing ICU mechanical ventilation procedures, sedation strategies and regulatory environment factors. Due to the complexity and specificity of criti- cally ill patients, the research on the prevention of delirium moves slowly. In the future, more large trials are needed to fur- ther confirm the effect of the prevention of delirium in ICU as well as to clarify its pathophysiology.
出处
《医学综述》
2017年第13期2596-2600,共5页
Medical Recapitulate
关键词
谵妄
重症监护室
镇静
预防
Delirium
Intensive care unit
Sedation
Prevention
