体外循环心脏术后精神障碍分析

An analysis of psychonosema after cardiac bypass operation

目的提高对体外循环心脏术后并发精神障碍的预防和诊治水平。方法回顾性分析1865例施行体外循环心脏手术患者资料,分析73例并发精神障碍的危险因素、临床表现、治疗方法、疗效及预后。结果本组患者并发精神障碍的发生率为3.9%,死亡3例,余均痊愈出院。结论术前危险因素包括高龄、心功能水平低下等;术中危险因素包括手术类型、体外循环及其时间、手术及转流技术;术后危险因素包括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;治疗上强调找出并消除潜在的致病因素,按精神病学疾病治疗,以控制行为障碍及精神症状。

Objective To improve the level of prevention,diagnosis and treatment for psychonosema after cardiac bypass operation. Methods Retrospective analysis of 1 865 patients undergoing cardiac surgery was made.73 patients who had psychosis were analyzed,the risk of postoperative psychosis after cardiac surgery,clinical manifestations treatment methods,efficacy and prognosis was also analyzed. Results The incidence of postoperative psychnnosema is 3.9%.After the treatment,70 patients fully recovered while 3 patients died. Conclusion Aging,low cardiac function etc are preoperative risk factors,operative types,duration of extracorporeal circulation and its duration,operation,and shunt are factors in the operation;duration of ICU stay,hyperstimulation,drng abuse,cardiorespiratory insufficiency and infection are postoperative factors.The treatment includes getting rid of those potential etiological factors,using psychiatric therapies to confrol behavioral disturbance and psychiatric symptom.