气管切开下行改良电休克治疗合并重症肺炎的紧张症1例

Successful treatment of a patient with catatonia and sever pneumonia using modified electroconvulsive therapy performed with tracheotomy

紧张症是一组严重的精神运动综合征,影响患者运动、言语和复杂行为。患者常表现为主动运动、言语、排痰、排便、进食行为减少的精神运动性抑制状态。紧张症患者因全身肌肉紧张、吞咽和咳嗽反射减少等疾病因素,以及长期卧床约束、镇静催眠药物应用等治疗因素,均会增加患者吸入性肺炎、重症肺炎及急性呼吸窘迫综合征发生的风险,严重影响患者精神疾病的治疗、转归及生命安全。本文报道1例合并重症肺炎及急性呼吸窘迫综合征的紧张症患者在气管切开下行改良电休克治疗后,紧张症及重症肺炎好转的过程,希望为精神专科医师提供借鉴,在治疗此类患者时能够合理选择治疗方案,尽快改善病情。

Catatonia is a group of severe psychomotor syndromes that affect patients'motor function,speech,and complex behaviors.Patients with catatonia typically display rigidity accompanied by decreased mobility,speech,sputum production,defecation,and eating.Both catatonia-related risks,such as increased muscle tension,reduced swallowing,and coughing reflexes,and risks attributed to therapeutic methods,such as prolonged bed rest and sedative drugs,can increase the risk of aspiration pneumonia,severe pneumonia,and acute respiratory failure.These conditions and complications can seriously affect the treatment of catatonia,lead to poor prognosis,and threaten the patient's safety.This paper reports a patient with catatonia combined with severe pneumonia and respiratory distress syndrome recovered after modified electroconvulsive therapy(MECT)under tracheotomy.This case report can offer valuable insights for psychiatrists when facing similar cases and assist in making rational therapeutic plans to improve the condition as soon as possible.