譫妄症臨床診治

Clinical Management of Delirium

10.6317/LTC.21.81

楊鎮嘉(Jen-Jia Yang)；高玉娟(Yu-Chuan Kao)

老人 ； 認知功能 ； 混亂評估法 ； 抗精神病藥物 ； elderly ； cognitive function ； Confusion Assessment Method (CAM) ； antipsychotic

長期照護雜誌

21卷2期（2017 / 09 / 01）

81 - 92

繁體中文

譫妄症是急性專注力及認知功能的病態改變，尤其常發生於65歲以上的老年族群，譫妄症會造成龐大的醫療花費，且易被忽略，更可能進一步造成老年病患的死亡。譫妄症常需要多方向並進的治療，主要是由於它常是多重因素所共同造成的臨床表現。目前並無強力的證據顯示有真正有功效的藥物治療，反而會建議減少使用止痛鎮靜藥物及進行非藥物的介入處理方式。譫妄症是病人安全的重要指標，所以我們將在文中探討譫妄症相關最新的診療方針及病理生理機轉。

Delirium is some form of acute pathological changes for attention and cognitive function, especially for those who are more than 65 years old. Delirium often costs a lot of medical resources, and it is often ignored. Furthermore, it could result in morbidity and mortality in the elderly. Due to the multifactorial causes, the management of delirium usually needs multi-directional treatment. At present, there is no strong evidence for any specific medication to treat delirium. On the contrary, we suggest tapering the dosage of analgesics, sedatives, and hypnotics, and recommend non-pharmacological management for the management of delirium. The care quality of delirium is an important indicator for the patient safety issue. Therefore, we will discuss about the pathophysiological mechanisms and treatment strategies of delirium in the elderly.

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