心脏术后患者精神障碍分析

Psychonosema after cardiac surgery

目的 :为提高对心脏术后并发精神障碍的预防和诊治水平。 方法 :分析心脏手术后发生精神障碍的危险因素、临床表现、治疗方法、疗效及预后。 结果 :本组病例并发精神障碍的发生率为 4 81% (6 2 / 12 89) ,5 9例患者治愈 ,3例死亡。 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、气管插管持续时间、过度刺激、药物的滥用以及心肺功能不全、感染等。治疗包括 :①找出并消除潜在的致病因素 ;②按精神病学疾病治疗 。

Objectives:To improve the level of prevention, diagnosis and treatment for psychonosema after cardiac surgery. Methods:Analyzing the risk factors, clinical situation, treatment methods, curative effect and prognosis of psychonosema. Results:The incidence of postoperative psychonosema is 4.81% (62/1 289) .After the treatment,59 patients fully recovered while 3 patient died. Conclusions:Aging, degree of cardiovascular impairment, etc, were preoperative risk factors that may be responsible for postoperative psychonosema. Type of operations, technical procedure and duration of extracorporeal circulation were intraoperative risk factors. In the postoperative period, the duration of intubation or ICU stay, hyper stimulation, drug abuse, cardiorespiratory insufficiency, infection, etc. were identified as significant predictors. The treatment includes:①to get rid of those potential etiological factors.②using psychiatric therapies to control psychiatric symptom and behavioral disturbance.