老年谵妄的临床特点

Clinical characteristics of the elderly patients with delirium

目的分析老年谵妄患者在综合医院会诊中的特点。方法对明确诊断为谵妄的102例患者，与同期会诊的老年患者进行比较，并对谵妄患者的临床特点进行分析。结果谵妄组患者的平均年龄高于对照组，差异有统计学意义（t=4．84，P〈0．05）。谵妄组患者在手术或创伤后、多器官衰竭方面比例高于对照组（23．5％vs9．3％，51．0％vs17．30%），上述差并有统计学意义（X^2=3．53，6．21，P〈0．05）。谵妄组患者会诊的首要原因在行为畀常和认知障碍方面较对照组明显（38．2％vs9．4％，35．1％vs11．6％），差并有统计学意义（X^2=5．13，2．57，P〈0．05）。谵妄患者临床表现：意识障碍，定向障碍，幻觉，注意障碍，记忆障碍等。误诊23例（22．6％）。谵妄患者中73例（71．6％）应用抗精神病药物治疗。结论应加强对老年谵妄临床特征的认识，争取做到早发现早治疗。

Objective To analyze the characteristics of elderly patients with delirium in the general hospital consultation. Methods One hundred and two elderly patients with delirium were compared with elderly patients in the same period in consultation, and the clinical characteristics of delirium was analyzed. Results The average age of delirium group was higher than that of the control group, and the difference was statistically significant（ t = 4.84, P 〈 0.05 ）. The rate of delirium patients suffering from surgery or trauma, multiple organ failure were higher than those of control group（23.5% vs 9.3% , 51.0% vs 17.3% ） , tile difference was statistically significant （ P 〈 0.05 ）. The delirium group patients consultation leading cause was behavioral abnormalities and cognitive impairment, compared with the control group（38.2% vs 9. 4% , 31.4% vs 3.2% ）, the difference was statistically signifieant（P 〈0. 05 ）. The clinical manifestations of patients with delirium： disturbance of consciousness, disorientation, hallucinations, attention disorders, memory disorders etc. The misdiagnosed were 23 eases（22.6% ）. Seventy-three cases（71.6% ） of delirium were given antipsychotic treatment. Conclusions We should enhance the understanding of the clinical ihatures of senile delirium, and strive for the early detection and early treatment.