ICU谵妄的研究进展

Delirium in the critically ill patient

ICU谵妄是一种急性的认知功能障碍,其发病机制仍不十分清楚。临床可通过精神疾病诊断与统计手册第五版(DSM-Ⅴ)、ICU意识模糊评估法(CAM-ICU)、重症监护谵妄筛查量表(ICDSC)、护理谵妄筛查量表(NU-DESC)、简易智能精神状态检查量表(MMSE)等量表进行诊断,其中CAM-ICU临床应用比较广泛。及早进行预防,可减少ICU谵妄的发生率,其方法分为药物性和非药物性两类。目前临床尚无特异性治疗方法,输注右美托咪定镇静可减少患者的谵妄持续时间。

ICU delirium is defined as an acute cognitive dysfunction, the pathophysiology of delirium is still unclear. A variety of tools exist for the diagnosis of delirium, but only the DSM-Ⅴ, CAM-ICU, intensive care delirium screening checklist(ICDSC), nursing delirium screening scale(NU-DESC) and mini-mental state examination(MMSE) have been validated in the critically ill patients, and the CAM-ICU is the most common tool. Nonpharmacological and pharmacological interventions to prevent delirium as early as possible can reduce incidence rate. At present, there is no specific treatment of delirium, but dexmedetomidine can shorten time of duration.