术后妄想:识别患有风险的患者并改变病程:叙述性综述
Danny Feike Hoogma1, Koen Milisen1, Steffen Rex1
1From the University Hospitals Leuven, Department of Anaesthesiology, KU Leuven, Herestraat 49, B-3000, Leuven, Belgium (DFH, SR, LA), University Leuven, Biomedical Sciences Group, Department of Cardiovascular Sciences, KU Leuven, Herestraat 49, B-3000, Leuven, Belgium (DFH, SR, LA), University Hospitals Leuven, Geriatric Medicine and Department of Public Health and Primary Care, KU Leuven, B-3000, Leuven, Belgium (KM).
手术后妄 (POD) 是老年人手术后常见的并发症,导致更糟糕的结果. 识别有风险的患者是预防和管理战略的关键.
科学领域:
- 老年医学 老年医学
- 神经科学是一个神经科学.
- 外科手术的结果
背景情况:
- 手术后痴呆症 (POD) 是经历重大手术的老年患者经常出现的神经认知并发症.
- POD与增加住院时间,重症监护室 (ICU) 入院,术后并发症,功能衰退和死亡率有关.
- 精确的POD病理生理学仍然不完全理解,尽管已确认了几种风险因素.
研究的目的:
- 审查识别患有术后妄想风险的患者的方法.
- 总结当前的证据和最佳实践,用于POD的术后预防和管理.
主要方法:
- 关于风险因素,病理生理学和预防POD的研究的文献综述.
- 关于外科手术期间管理策略的证据综合.
- 对预防POD的最佳实践建议的分析.
主要成果:
- 确定了关键的风险因素,包括晚年,特定的手术类型 (心脏,部),先前存在的认知障碍和生理障碍 (神经递质失衡,氧化应激,神经炎症).
- 强调了早期风险识别对资源分配和有针对性的干预措施的重要性.
- 总结了基于证据的术后护理建议,以减轻POD风险.
结论:
- 早期识别患有POD风险的患者对于优化术后护理至关重要.
- 实施有针对性的预防和管理策略可以改善老年手术患者的治疗结果.
- 对POD病理生理学的进一步研究可能会产生更有效的干预措施.
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