Делирий в послеоперационном периоде: этиология, патогенез, интенсивная терапия

Автор: Красносельский Михаил Яковлевич, Политов Михаил Евгеньевич

Журнал: Хирургическая практика @spractice

Рубрика: Хирургия и смежные специальности

Статья в выпуске: 2, 2013 года.

Бесплатный доступ

Психические нарушения в послеоперационном периоде, в частности делирий, развиваются у 10-80% больных. Послеоперационный делирий (ПД) существенно увеличивает длительность пребывания больного в стационаре и послеоперационную летальность. В патогенезе делирия принимают участие различные факторы, важнейшим из которых является хирургический стресс-ответ с активацией симпатоадреналовой системы и системной воспалительной реакцией. Предрасполагающими факторами к развитию ПД являются предшествующие когнитивные нарушения, алкоголизм, а также некупированная боль, лихорадка и другие послеоперационные осложнения. В настоящее время выделяют гиперактивную, гипоактивную и смешанную формы ПД. Интенсивная терапия ПД включает назначение нейролептиков (галоперидола, оланзапина). Обсуждается превентивное введение низких доз галоперидола у больных с высоким риском ПД.

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Послеоперационный делирий, когнитивные нарушения, анестезиологическое обеспечение, профилактика делирия

Короткий адрес: https://sciup.org/142211518

IDR: 142211518

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