生命末期,并非一切都是妄想:一个病例报告
Daniel Gilbey1, Eduardo Bruera1, Patricia S Bramati1
1Department of Palliative Care, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Annals of palliative medicine
|September 11, 2025
概括
在生命末期的妄想是具有挑战性的. 一位经历激动的患者被发现受到非侵入性胆脉通风的困扰,在切换到高流量氧气后,这种情况得到解决.
科学领域:
- 抚慰性护理是一种缓解性护理.
- 神经科学是一个神经科学.
- 在瘤学瘤学.
背景情况:
- 狂妄症是生命末期患者常见的,令人痛苦的疾病.
- 鉴定妄想的原因是困难的,可用的管理选择有限.
- 沟通障碍可能会使妄的评估和治疗变得复杂.
研究的目的:
- 报告患有转移性神经内分泌瘤的患者 Delirium 的病例.
- 突出诊断痴呆症的挑战,特别是语言障碍.
- 强调非侵入性双层通风在引起妄想方面的潜在作用.
主要方法:
- 一个60多岁末期患有转移性神经内分泌瘤的病人的案例研究.
- 这名患者被送入缓解护理病房,接受非侵入性双层通风.
- 非药物干预和随后的药物治疗是由于兴奋而进行的.
主要成果:
- 患者的激动和妄想症状归因于非侵入性的双层通风面罩.
- 通过鼻管过渡到高流氧导致呼吸困难和认知状态的快速改善.
- 患者能够表达自己的不适,而此前这种不适被激动所掩盖.
结论:
- 在终身护理中,应仔细考虑非侵入性双层通风,因为它有可能导致或加剧妄想.
- 临床团队必须在评估潜在的催情性狂妄病原因时保持警,特别是在有沟通障碍的患者中.
- 有效的沟通和以患者为中心的护理对于在息环境中管理妄想至关重要.
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