心脏术后精神病性障碍的临床分析

A Clinical Analysis of Mental Disorder after Cardiac Surgery

目的 研究心脏手术后精神病性障碍的病因、发病机理及防治措施。方法 对2 86例心脏手术病人进行回顾性分析,研究心脏手术后发生精神病性障碍的危险因素、临床表现、治疗方法、疗效及预后。结果 本组中共有10例病人出现精神病性障碍并发症,发生率为3.4 9% ,10例患者均治愈出院。结论 术前的危险因素有高龄、心功能水平低下等;术中因素有手术类型、体外循环及其时间、手术及转流技术;术后因素包括ICU停留时间、过度刺激、药物的不恰当使用以及心肺功能不全、感染等。治疗包括:找出并消除潜在的致病因素;按精神病学疾病治疗,以控制精神症状及行为障碍。

Objectives To assay the etiology, pathogenesis, prevention and treatment measures of postoperative psychosis after cardiac surgery. Methods Refrospective analysis of 286 patients undergoing cardiac surgery was made.The risks of postoperative psychosis after cardiac surgery,clinical manifestations treatment methods,efficacy and pregnosis were also analyzed. Results There were 10 patients who had psycosis and its complications.The incidence rate was 3.49%(10/286) and all of them were well enough to be dischanged from the hospital. Conclusions Aging, low cardiac function etc are preoprative risk factors,operative types,duration of exfracorporeal circulation and its duration,operation,and shunt are factors in the operation;duration of ICU stay,hyperstimulation,drug abuse,cardiorespiratory insnfficiency and infection are postoperative factors.The freatment includes getting rid of those potential etiological factors,using psychiatric therapies to confral psychiafric symptom and behavioral disturbance.