重症监护病房患者谵妄病例讨论

ICU patients with delirium case discussion

背景：有效预防入住重症监护病房患者发生谵妄，对降低其负面影响至关重要。目的：探讨重症监护病房患者发生谵妄的病因，以便于早期诊断和治疗。方法：对2011年1月至2014年1月期间入住急诊科重症监护病房的50例发生谵妄的危重创伤患者的原发病、精神症状、预后进行分析。结果与结论：50例发生谵妄的危重患者的原发病病因：颅脑外伤16例（32％）、胸外伤12例（24％），胸腹多发伤3例（6％），脓毒症休克7例（14％），重症肺炎4例（8％），中毒6例（12％），心肺复苏后2例（4％）。对原发病积极治疗，早期给予干预治疗，精神症状持续时间1周至3个月，精神症状治愈卒100％。结果证实，重症监护病房危重创伤患者发生精神症状的病因是多样化的，只要尽早诊断、早干预和积极治疗原发病，绝大部分患者精神症状可治愈。

BACKGROUND： To investigate the cause of delirium in ~CU patients, in order to facilitate early diagnosis and treatment. Methods： For 2011 January 1 January 2014 during the ICU stay of 50 cases of emergency department patients with delirium in critically ill trauma of the primary disease, psychiatric symptoms, the prognosis for analysis. Primary disease etiology. Results： 50 cases occur in critically ill patients with delirium： traumatic brain injury 16 cases （32%）, chest trauma 12 cases （24%）, abdominal multiple injuries three cases （6%）, septic shock 7 cases （14%）, severe pneumonia four cases （8%）, poisoning six cases （12%）, 2 cases （4%） after cardiopulmonary resuscitation. The results of this group of patients for aggressive treatment of the primary disease, given early intervention, psychiatric symptoms duration of one week to three months, psychiatric symptoms cure Death 100%. Conclusion： critically ill trauma ICU patients the etiology of psychiatric symptoms are diverse, as long as early diagnosis, early intervention and treatment of the primary disease, the vast majority of psychiatric symptoms in patients can be cured.