终末期患者谵妄的研究进展

随着安宁疗护在中国的发展,患者生命末期生存质量得到越来越多的关注,终末期患者症状控制的研究日益增加。谵妄是终末期患者最常见的症状之一,具有发生率高、漏诊率高、危险性高等特点,延长了住院周期,增加了经济负担,也增加了跌倒、压力性损伤、意外拔管等风险,加速了死亡进程。尽管提倡以跨学科协作团队管理谵妄,但管理效果仍不理想,缺少对谵妄的正确认知、评估与干预,降低了安宁疗护照护质量。该文综述终末期患者谵妄特点、国内外常用谵妄评估工具、危险因素、药物及非药物干预措施,以期为终末期患者制订有效的谵妄管理方案提供借鉴。

Research progress on delirium in end-of-life patients with hospice care

With the development of hospice care,the quality of life at the end of life receives much attention,and the research on the symptom control of terminal-stage patients is increasing. Delirium is one of the most common symptoms in terminal-stage patients,which is characterised by high incidence,high rate of missed diagnosis and high risks. Delirium extends the hospitalization cycle,increases the economic burden,increases the risk of falling,stress injury and accidental extubation,and accelerates the death process. Although an interdisciplinary team is advocated to manage delirium,the effect still remains unsatisfactory with inadequate cognition,evaluation and intervention,reducing the quality of hospice care.The paper reviews the characteristics of delirium,commonly used assessment tools,risk factors,drug and non-drug interventions for the development of effective delirium management programs for terminal-stage patients.