老年髋部骨折术后谵妄防治进展
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摘要
谵妄,又称急性脑综合征,主要表现为意识、睡眠及精神运动障碍,具有急性发作、波动性和可逆性的特点。髋部骨折是引起术后谵妄的最主要原因,其致死率,致残率均较高,在骨科中与下肢深静脉血栓、肺栓塞等并发症同等重要。本文就老年髋部骨折术后谵妄的预防与治疗进行综述,现整理如下。
Hemorrhoids,also known as acute brain syndrome,mainly manifests as disorders in consciousness,sleep and psychomotor,characterized by acute attacks,volatility and reversibility. Hip fracture is the leading cause of postoperative delirium, and its lethality rate and disability rate are both comparatively high. It is of equal importance in orthopedics with complications such as deep vein thrombosis and pulmonary embolism. Authors in this article reviewed the prevention and treatment for delirium in senile patients after hip fracture and organized it as follows.
Hemorrhoids,also known as acute brain syndrome,mainly manifests as disorders in consciousness,sleep and psychomotor,characterized by acute attacks,volatility and reversibility. Hip fracture is the leading cause of postoperative delirium, and its lethality rate and disability rate are both comparatively high. It is of equal importance in orthopedics with complications such as deep vein thrombosis and pulmonary embolism. Authors in this article reviewed the prevention and treatment for delirium in senile patients after hip fracture and organized it as follows.
引文
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[2]刘天琳,霍星,王国年,等.谵妄病理生理机制研究进展[J].新乡医学院学报,2014,31(12):1057-1060.
[3]胡维,周明全,谭祖键,等.高龄髋部骨折患者术后谵妄的高危因素分析[J].创伤外科杂志,2014,16(4):324-327.
[4]喻任,陆纯德,程艳,等.高龄髋部骨折患者术后谵妄危险因素调查[J].中国骨与关节损伤杂志,2016,31(4):341-344.
[5]Johnson RL,kopp SL,Burkle CM,et al.Neuraxial vs general anaesthesia for total hip and total knee arthroplasty:a systematic review of comparative-effectiveness research[J].Br J Anaesth,2016,116(2):163-176.
[6]黄艳,钟华,熊理锋,等.局部麻醉与全身麻醉对老年髋部骨折术后谵妄的影响[J].锦州医科大学学报,2017,38(4):92-95.
[7]张立智,张世民.老年髋部骨折术后谵妄的研究进展[J].中国矫形外科杂志,2014,22(4):324-327.
[8]Boddaert J,Raux M,Khiami F,et al.Perioperatuve management of elderly patients with hip fracture[J].Anesthesiology,2014,121(6):1336-1341.
[9]Ventura C,Trombetti S,Pioli G,et al.Impact of multidisciplinary hip fracture program on timing of surgery in elderly patients[J].Osteoporos Int,2014,25(11):2591-2597.
[10]伍红带.健脑手指经络拍打操预防老年髋部骨折患者术后谵妄的效果观察[J].实用临床护理学电子杂志,2016,1(9):147,149.
[11]朱读伟,严谨.国外老年谵妄护理管理现状[J].老年护理专题,2017,6(17):796-798.
[12]汪财霞,郭丽,何丁香,等.集束化策略预防老年髋部骨折患者术后谵妄的效果[J].安徽医学,2017,38(2):236-239.
[13]王瑞敏,张静.老年髋部骨折术后谵妄的预防及护理干预[J].河北中医,2014,12(36):1892-1893.
[14]瓮科迪,曹铨,石钢,等.帕瑞昔布钠超前镇痛对老年股骨转子间骨折术后镇痛及谵妄的影响[J].浙江中西医结合杂志,2016,26(8):741-744.
[15]周雁,史婧,种皓,等.院前区域阻滞镇痛对老年髋部骨折患者疼痛控制及其全身情况影响的前瞻性研究[J].中国骨与关节杂志,2017,6(3):180-185.
[16]姚翔燕,孟凡民,张加强,等.右美托咪定和瑞芬太尼对老年髋部骨折手术患者术后谵妄的效果比较[J].河南外科学杂志,2015,21(2):42-43.
[17]钟赤平,卢军.醒脑静注射液在老年患者谵妄中的临床应用[J].当代医学杂志,2013,19(34):137-138.
[18]赵志辉.醒脑静注射液预防性治疗高龄患者髋部骨折术后谵妄60例[J].武警后勤学院学报,2016,25(1):50-51.
[19]郑强,魏彭辉,李建军,等.乌司他丁对老年患者髋部骨折术后谵妄的影响[J].临床麻醉学杂志,2017,33(3):236-239.
[20]Vochteloo AJ,Moerman S,van der Burg BL,et al.Delirium risk screening and haloperidol prophylaxis program in hip fracture patients is a helpful tool in identifying high-risk patients,but does not reduce the incidence of delirium[J].BMC Geriatr,2011,11:39.
[21]王正,王瑞平,薛启明,等.中西医结合预防股骨粗隆间骨折术后谵妄效果观察[J].实用中医药杂志,2017,33(10):1151-1152.
[22]孙哲,张宏军,范客杰,等.活血养心汤治疗老年髋部骨折术后谵妄疗效分析[J].亚太传统医药,2016,12(24):147-148.
[23]吕存贤,童培建.补阳还五汤对高龄髋部骨折术后谵妄的治疗作用[J].中医正骨,2010,22(1):15-17.
[24]毕梦娜,张鹏,陈经勇.癫狂梦醒汤加减方治疗高龄髋部骨折术后活动过多型谵妄的临床研究[J].中国中医骨伤科杂志,2014,22(12):28-31.
[25]董慧领,陈庆国,张惠艳.术后针灸干预对高龄患者股骨粗隆间骨折术后谵妄的影响[J].中国保健营养,2014(10下):52-53.
[26]郑伟,杜夕桥,张锦.中药穴位贴敷对防治老年髋部骨折术后谵妄的临床观察[J].大家健康,2014,8(11):45.
[27]Kim BG,Lee YK,Park HP,et al.C-reactive protein is an independent predictor for 1-year mortality in elderlypatients undegoing hip fracture surgery:A retrospective analysis[J]Medicine(Baltimore),2016,95(43):e5152.
[2]刘天琳,霍星,王国年,等.谵妄病理生理机制研究进展[J].新乡医学院学报,2014,31(12):1057-1060.
[3]胡维,周明全,谭祖键,等.高龄髋部骨折患者术后谵妄的高危因素分析[J].创伤外科杂志,2014,16(4):324-327.
[4]喻任,陆纯德,程艳,等.高龄髋部骨折患者术后谵妄危险因素调查[J].中国骨与关节损伤杂志,2016,31(4):341-344.
[5]Johnson RL,kopp SL,Burkle CM,et al.Neuraxial vs general anaesthesia for total hip and total knee arthroplasty:a systematic review of comparative-effectiveness research[J].Br J Anaesth,2016,116(2):163-176.
[6]黄艳,钟华,熊理锋,等.局部麻醉与全身麻醉对老年髋部骨折术后谵妄的影响[J].锦州医科大学学报,2017,38(4):92-95.
[7]张立智,张世民.老年髋部骨折术后谵妄的研究进展[J].中国矫形外科杂志,2014,22(4):324-327.
[8]Boddaert J,Raux M,Khiami F,et al.Perioperatuve management of elderly patients with hip fracture[J].Anesthesiology,2014,121(6):1336-1341.
[9]Ventura C,Trombetti S,Pioli G,et al.Impact of multidisciplinary hip fracture program on timing of surgery in elderly patients[J].Osteoporos Int,2014,25(11):2591-2597.
[10]伍红带.健脑手指经络拍打操预防老年髋部骨折患者术后谵妄的效果观察[J].实用临床护理学电子杂志,2016,1(9):147,149.
[11]朱读伟,严谨.国外老年谵妄护理管理现状[J].老年护理专题,2017,6(17):796-798.
[12]汪财霞,郭丽,何丁香,等.集束化策略预防老年髋部骨折患者术后谵妄的效果[J].安徽医学,2017,38(2):236-239.
[13]王瑞敏,张静.老年髋部骨折术后谵妄的预防及护理干预[J].河北中医,2014,12(36):1892-1893.
[14]瓮科迪,曹铨,石钢,等.帕瑞昔布钠超前镇痛对老年股骨转子间骨折术后镇痛及谵妄的影响[J].浙江中西医结合杂志,2016,26(8):741-744.
[15]周雁,史婧,种皓,等.院前区域阻滞镇痛对老年髋部骨折患者疼痛控制及其全身情况影响的前瞻性研究[J].中国骨与关节杂志,2017,6(3):180-185.
[16]姚翔燕,孟凡民,张加强,等.右美托咪定和瑞芬太尼对老年髋部骨折手术患者术后谵妄的效果比较[J].河南外科学杂志,2015,21(2):42-43.
[17]钟赤平,卢军.醒脑静注射液在老年患者谵妄中的临床应用[J].当代医学杂志,2013,19(34):137-138.
[18]赵志辉.醒脑静注射液预防性治疗高龄患者髋部骨折术后谵妄60例[J].武警后勤学院学报,2016,25(1):50-51.
[19]郑强,魏彭辉,李建军,等.乌司他丁对老年患者髋部骨折术后谵妄的影响[J].临床麻醉学杂志,2017,33(3):236-239.
[20]Vochteloo AJ,Moerman S,van der Burg BL,et al.Delirium risk screening and haloperidol prophylaxis program in hip fracture patients is a helpful tool in identifying high-risk patients,but does not reduce the incidence of delirium[J].BMC Geriatr,2011,11:39.
[21]王正,王瑞平,薛启明,等.中西医结合预防股骨粗隆间骨折术后谵妄效果观察[J].实用中医药杂志,2017,33(10):1151-1152.
[22]孙哲,张宏军,范客杰,等.活血养心汤治疗老年髋部骨折术后谵妄疗效分析[J].亚太传统医药,2016,12(24):147-148.
[23]吕存贤,童培建.补阳还五汤对高龄髋部骨折术后谵妄的治疗作用[J].中医正骨,2010,22(1):15-17.
[24]毕梦娜,张鹏,陈经勇.癫狂梦醒汤加减方治疗高龄髋部骨折术后活动过多型谵妄的临床研究[J].中国中医骨伤科杂志,2014,22(12):28-31.
[25]董慧领,陈庆国,张惠艳.术后针灸干预对高龄患者股骨粗隆间骨折术后谵妄的影响[J].中国保健营养,2014(10下):52-53.
[26]郑伟,杜夕桥,张锦.中药穴位贴敷对防治老年髋部骨折术后谵妄的临床观察[J].大家健康,2014,8(11):45.
[27]Kim BG,Lee YK,Park HP,et al.C-reactive protein is an independent predictor for 1-year mortality in elderlypatients undegoing hip fracture surgery:A retrospective analysis[J]Medicine(Baltimore),2016,95(43):e5152.