相关实验视频
手术后妄想:一名76岁的妇女在手术后出现妄想
1Division of General Medicine and Primary Care, Department of Medicine, Beth Israel Deaconess Medical Center, and Harvard Medical School, Boston, Massachusetts 02215, USA. emarcant@bidmc.harvard.edu
JAMA
|June 7, 2012
概括
手术后痴呆症是老年人常见的并发症,临床医生经常忽略,但可以预防和治疗. 针对风险因素的积极,多因素干预是管理这种疾病的关键.
科学领域:
- 老年医学 老年医学
- 麻醉学 麻醉学
- 临界护理医学 临界护理医学
背景情况:
- Delirium (急性混乱) 影响15%-50%的接受重大手术的老年人.
- 它与长时间住院,功能衰退和死亡率增加等不良结果有关.
- 尽管患病率和影响很高,但术后妄想常常没有被识别和治疗.
研究的目的:
- 审查手术后狂妄症的诊断,预防和治疗.
- 突出主动干预在治疗老年外科病人的狂妄症的重要性.
- 用一个临床案例来说明这些概念.
主要方法:
- 关于术后妄想诊断,风险因素和管理策略的文献综述.
- 一个76岁的女性患者经历了手术后 Delirium 的案例研究介绍.
- 讨论多因素干预措施的讨论,以针对倾向性和冲击性因素为目标.
主要成果:
- 术后妄想风险可以通过总结易感和诱发因素来量化.
- 有效的预防和治疗需要积极主动,多因素干预.
- 关键策略包括限制镇静剂,控制疼痛,并可能使用抗精神病药物.
结论:
- 狂妄症是老年手术患者的重大并发症,通常是可以预防的.
- 早期识别和有针对性的干预措施对于改善结果至关重要.
- 针对可修改的风险因素的综合方法对于管理术后妄想是必不可少的.
相关概念视频
Cardiomyopathy VII: Pre and Post Operative Nursing Management
Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Peripheral Artery Disease V: Postoperative Nursing Management
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
Aneurysm IV: Nursing Management
Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
Stages of General Anesthesia
Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...
Appendicitis-II: Diagnostic Studies and Management
Diagnosing and managing appendicitis requires a structured and comprehensive approach that spans from initial assessment to postoperative care. Here is an overview of the process:
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...