ICU谵妄的研究进展

Research progress of delirium in intensive care unit

谵妄是一种急性脑功能障碍综合征,在成人危重症患者中较常见。谵妄的发病机制与神经炎症、神经递质失衡、异常应激和脑组织缺血相关。在重症监护病房(ICU)中,谵妄的发生与患者的长期认知功能障碍有关,有效的评估工具能够尽早发现ICU谵妄,及早干预治疗可能能够改善患者预后。然而,目前尚无特异性方案用于ICU谵妄的治疗,所以积极预防显得尤为重要。本文对ICU谵妄的危险因素、发病机制、诊断、治疗和预防进行综述,以期加深对ICU谵妄的理解,进而对其进行规范的管理。

Delirium is an acute brain dysfunction syndrome that is common in adult critical care patients.The pathogenesis of delirium is highly related with neuroinflammation,neurotransmitter imbalance,abnormal stress response,and cerebral ischemia.In intensive care unit(ICU),the occurrence of delirium is accompanied with long-term cognitive impairment in patients.Effective assessment tools can detect ICU delirium as early as possible,and subsequent treatment can improve the clinical outcome.However,there are no specific protocols for the treatment of ICU delirium,and active prevention is of particular important.This narrative review aims to address the risk factors,pathogenesis,diagnosis,treatment and prevention of ICU delirium,with a view to increase the understanding of ICU delirium and standardize management.