精神疾病患者无抽搐电休克术后谵妄影响因素及干预措施的研究进展
Research Progress on Influencing Factors and Intervention Measures of Postoperative Delirium in Patients with Mental Disorders Undergoing Modified Electroconvulsive Therapy
DOI: 10.12677/ACM.2024.141001, PDF,   
作者: 艾宪英:滨州医学院护理学院,山东 滨州;山东省精神卫生中心精神科,山东 济南;王盛源, 郑崇泉*, 史振春*:山东省精神卫生中心精神科,山东 济南
关键词: 改良电休克术后谵妄影响因素干预措施综述护理Modified Electroconvulsive Therapy Postoperative Delirium Influencing Factors Intervention Measures Review Nursing
摘要: 术后谵妄是精神疾病患者改良电休克(MECT)治疗后的常见并发症之一,严重影响患者的预后。本文从疾病本身因素、评估工具、患者自身易感因素以及诱发因素进行综述,并梳理了相关干预措施,以提高临床医护对MECT患者谵妄的识别能力,促进精神疾病患者改良电休克治疗后谵妄预防、监测及管理。
Abstract: Postoperative delirium is one of the common complications after modified electroconvulsive thera-py (MECT) in patients with mental disorders, which seriously affects their prognosis. This article re-views the factors of the disease itself, evaluation tools, patient susceptibility factors, and triggering factors, and summarizes relevant intervention measures to improve the recognition ability of clini-cal healthcare for delirium in MECT patients, and promote the prevention, monitoring, and man-agement of delirium in patients with mental disorders after improved electroconvulsive therapy.
文章引用:艾宪英, 王盛源, 郑崇泉, 史振春. 精神疾病患者无抽搐电休克术后谵妄影响因素及干预措施的研究进展[J]. 临床医学进展, 2024, 14(1): 1-8. https://doi.org/10.12677/ACM.2024.141001

参考文献

[1] 杜飞. 基于临床血检数据的精神疾病辅助诊断模型构建[D]: [硕士或博士学位论文]. 厦门: 厦门大学, 2020.
[2] Lava-Parmele, S., Lava, C. and Parmele, J.B. (2021) The Historical Struggles of Modified Electroconvulsive Therapy: How Anesthesia Came to the Rescue. Journal of Anesthesia History, 7, 17-25. [Google Scholar] [CrossRef] [PubMed]
[3] Hughes, C.G., Boncyk, C.S., Culley, D.J., Fleisher, L.A., Leung, J.M., McDonagh, D.L., Gan, T.J., McEvoy, M.D., Miller, T.E. and Perioperative Quality Initiative (POQI) 6 Workgroup (2020) American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on Postoperative Delirium Prevention. Anesthesia and Analgesia, 130, 1572-1590. [Google Scholar] [CrossRef
[4] Jo, Y.T., Joo, S.W., Lee, J. and Joo, Y.H. (2021) Factors Associated with Post-Electroconvulsive Therapy Delirium: A Retrospective Chart Review Study. Medicine, 100, e24508. [Google Scholar] [CrossRef
[5] 李艳茹, 姜玮, 赵希希, 等. 无抽搐电休克治疗术后谵妄危险因素分析[J]. 中国神经精神疾病杂志, 2020, 46(12): 721-724.
[6] 潘燕彬, 颜建龙, 骆谏英, 等. 谵妄患者远期预后的研究进展[J]. 中华护理杂志, 2019, 54(9): 1415-1418.
[7] Aldecoa, C., Bettelli, G., Bilotta, F., Sanders, R.D., Aceto, P., Audisio, R., Cherubini, A., Cunningham, C., Dabrowski, W., Forookhi, A., Gitti, N., Immonen, K., Kehlet, H., Koch, S., Kotfis, K., Latronico, N., MacLullich, A.M.J., Mevorach, L., Mueller, A., Neuner, B., Spies, C.D., et al. (2023). Update of the European Society of Anaesthesiology and Intensive Care Medicine Evidence-Based and Consensus-Based Guideline on Postoperative Delirium in Adult Patients. European Journal of Anaesthesiology.[CrossRef
[8] 何欢, 刘博雅, 彭川, 等. 基于LASSO回归的无抽搐电休克治疗术后谵妄风险预测模型的建立[J]. 精神医学杂志, 2022, 35(6): 613-619.
[9] Aldecoa, C., Bettelli, G., Bilotta, F., Sanders, R.D., Audisio, R., Borozdina, A., Cherubini, A., Jones, C., Kehlet, H., MacLullich, A., Radtke, F., Riese, F., Slooter, A.J., Veyckemans, F., Kramer, S., Neuner, B., Weiss, B. and Spies, C.D. (2017) European Society of Anaesthesiology Evidence-Based and Consensus-Based Guideline on Postoperative Delirium. European Journal of An-aesthesiology, 34, 192-214. [Google Scholar] [CrossRef
[10] 杨雪, 姜玮, 任艳萍, 等. 改良电休克治疗后不同亚型谵妄的相关因素分析[J]. 中华精神科杂志, 2016, 49(5): 312-316.
[11] Zalon, M.L., Sandhaus, S., Kovaleski, M. and Roe-Prior, P. (2017) Hospitalized Older Adults with Established Delirium: Recognition, Documentation, and Reporting. Journal of Gerontological Nursing, 43, 32-40. [Google Scholar] [CrossRef] [PubMed]
[12] Abengaña, J., Chong, M.S. and Tay, L. (2017) Delirium Su-perimposed on Dementia: Phenomenological Differences between Patients with and without Behavioral and Psychologi-cal Symptoms of Dementia in a Specialized Delirium Unit. International Psychogeriatrics, 29, 485-495. [Google Scholar] [CrossRef
[13] Sessler, C.N., Gosnell, M.S., Grap, M.J., Brophy, G.M., O’Neal, P.V., Keane, K.A., Tesoro, E.P. and Elswick, R.K. (2002) The Richmond Agitation-Sedation Scale: Validity and Reliability in Adult Intensive Care Unit Patients. American Journal of Respiratory and Critical Care Medicine, 166, 1338-1344. [Google Scholar] [CrossRef] [PubMed]
[14] 杨雪, 王喜今, 姜玮, 等. Richmond躁动镇静评分量表评估电休克治疗后谵妄的信度及效度[J]. 临床精神医学杂志, 2016, 26(2): 86-88.
[15] Inouye, S.K., van Dyck, C.H., Alessi, C.A., Balkin, S., Siegal, A.P. and Horwitz, R.I. (1990) Clarifying Confusion: The Confusion Assessment Method. A New Method for Detection of Delirium. Annals of Internal Medicine, 113, 941-948. [Google Scholar] [CrossRef] [PubMed]
[16] Tsujii, T., Uchida, T., Suzuki, T., Mimura, M., Hirano, J. and Uchida, H. (2019) Factors Associated With Delirium Following Electroconvulsive Therapy: A Systematic Review. The Journal of ECT, 35, 279-287. [Google Scholar] [CrossRef
[17] Fu, Z., Xu, Q., Zhang, C., Bai, H., Chen, X., Zhang, Y., Luo, W. and Lin, G. (2021) Admission Systolic Blood Pressure Predicts Post-Operative Delirium of Acute Aortic Dis-section Patients in the Intensive Care Unit. International Journal of General Medicine, 14, 5939-5948. [Google Scholar] [CrossRef
[18] Jung, P., Pereira, M.A., Hiebert, B., Song, X., Rockwood, K., Tangri, N. and Arora, R.C. (2015) The Impact of Frailty on Postoperative Delirium in Cardiac Surgery Patients. The Journal of Thoracic and Cardiovascular Surgery, 149, 869-875.E2. [Google Scholar] [CrossRef] [PubMed]
[19] Quinlan, N., Marcantonio, E.R., Inouye, S.K., Gill, T.M., Kamholz, B. and Rudolph, J.L. (2011) Vulnerability: The Crossroads of Frailty and Delirium. Journal of the American Geriatrics Society, 59, S262-S268. [Google Scholar] [CrossRef] [PubMed]
[20] Wada, S., Inoguchi, H., Sadahiro, R., Matsuoka, Y.J., Uchitomi, Y., Sato, T., Shimada, K., Yoshimoto, S., Daiko, H. and Shimizu, K. (2019) Preoperative Anxiety as a Pre-dictor of Delirium in Cancer Patients: A Prospective Observational Cohort Study. World Journal of Surgery, 43, 134-142. [Google Scholar] [CrossRef] [PubMed]
[21] Ren, A., Zhang, N., Zhu, H., Zhou, K., Cao, Y. and Liu, J. (2021) Effects of Preoperative Anxiety on Postoperative Delirium in Elderly Patients Undergoing Elective Orthopedic Surgery: A Prospective Observational Cohort Study. Clinical Interventions in Aging, 16, 549-557. [Google Scholar] [CrossRef
[22] Patel, R.S., Bachu, A. and Youssef, N.A. (2020) Combination of Lith-ium and Electroconvulsive Therapy (ECT) Is Associated with Higher Odds of Delirium and Cognitive Problems in a Large National Sample across the United States. Brain Stimulation, 13, 15-19. [Google Scholar] [CrossRef] [PubMed]
[23] Thom, R.P., Levy-Carrick, N.C., Bui, M. and Silbersweig, D. (2019) Delirium. The American Journal of Psychiatry, 176, 785-793. [Google Scholar] [CrossRef] [PubMed]
[24] Soiza, R.L. and Myint, P.K. (2019) The Scottish Intercolle-giate Guidelines Network (SIGN) 157: Guidelines on Risk Reduction and Management of Delirium. Medicina, 55, Arti-cle 491. [Google Scholar] [CrossRef] [PubMed]
[25] Bowman, E.M.L., Cunningham, E.L., Page, V.J. and McAuley, D.F. (2021) Phenotypes and Subphenotypes of Delirium: A Review of Current Categorisations and Sugges-tions for Progression. Critical Care, 25, Article No. 334. [Google Scholar] [CrossRef] [PubMed]
[26] Tonna, J.E., Dalton, A., Presson, A.P., Zhang, C., Colantuoni, E., Lander, K., Howard, S., Beynon, J. and Kamdar, B.B. (2021) The Effect of a Quality Improvement Intervention on Sleep and Delirium in Critically Ill Patients in a Surgical ICU. Chest, 160, 899-908. [Google Scholar] [CrossRef] [PubMed]
[27] Li, X., Cheng, N., Deng, Y., Du, J., Zhang, M., Guo, Y. and Hei, Z. (2020) Incidence and Risk Factors for Postictal Delirium in Patients after Electroconvulsive Therapy in China. Asian Journal of Psychiatry, 53, Article ID: 102361. [Google Scholar] [CrossRef] [PubMed]
[28] 中国医师协会神经调控专业委员会电休克与神经刺激学组, 中国医师协会睡眠专业委员会精神心理学组, 中国医师协会麻醉学医师分会. 改良电休克治疗专家共识(2019版) [J]. 转化医学杂志, 2019, 8(3): 129-134.
[29] Sasannejad, C., Ely, E.W. and Lahiri, S. (2019) Long-Term Cognitive Impairment after Acute Respiratory Distress Syndrome: A Review of Clinical Impact and Pathophysiological Mecha-nisms. Critical Care, 23, Article No. 352. [Google Scholar] [CrossRef] [PubMed]
[30] Evered, L.A., Chan, M.T.V., Han, R., Chu, M.H.M., Cheng, B.P., Scott, D.A., Pryor, K.O., Sessler, D.I., Veselis, R., Frampton, C., Sumner, M., Ayeni, A., Myles, P.S., Campbell, D., Leslie, K. and Short, T.G. (2021) Anaesthetic Depth and Delirium after Major Surgery: A Randomised Clinical Trial. British Journal of Anaesthesia, 127, 704-712. [Google Scholar] [CrossRef] [PubMed]
[31] Jiang, J.L., Zhang, L., He, L.L., Yu, H., Li, X.F., Dai, S.H. and Yu, H. (2023) Volatile versus Total Intravenous Anesthesia on Postoperative Delirium in Adult Patients Undergoing Cardiac Valve Surgery: A Randomized Clinical Trial. Anesthesia and Analgesia, 136, 60-69. [Google Scholar] [CrossRef
[32] Kikuchi, A., Yasui-Furukori, N., Fujii, A., Katagai, H. and Kaneko, S. (2009) Identification of Predictors of Post-Ictal Delirium after Electroconvulsive Therapy. Psychiatry and Clinical Neurosciences, 63, 180-185. [Google Scholar] [CrossRef] [PubMed]
[33] Burry, L., Hutton, B., Williamson, D.R., Mehta, S., Adhi-kari, N.K., Cheng, W., Ely, E.W., Egerod, I., Fergusson, D.A. and Rose, L. (2019) Pharmacological Interventions for the Treatment of Delirium in Critically Ill Adults. The Cochrane Database of Systematic Reviews, 9, CD011749. [Google Scholar] [CrossRef
[34] Qiu, Z., Zhou, S., Zhang, M., Guo, N., Huang, P., Xiang, P., Hei, Z. and Li, X. (2020) Preventive Effect of Dexmedetomidine on Postictal Delirium after Electroconvulsive Thera-py: A Randomised Controlled Study. European Journal of Anaesthesiology, 37, 5-13. [Google Scholar] [CrossRef
[35] National Institute for Health and Care Excellence (NICE) (2023) Delirium: Prevention, Diagnosis and Management in Hospital and Long-Term Care.
[36] Mattison, M.L.P. (2020) Delirium. Annals of Internal Medicine, 173, ITC49-ITC64. [Google Scholar] [CrossRef
[37] Arbabi, M., Ziaei, E., Amini, B., Ghadimi, H., Rashidi, F., Sho-hanizad, N., Moradi, S., Beikmarzehei, A., Hasanzadeh, A. and Parsaei, A. (2022) Delirium Risk Factors in Hospitalized Patient: A Comprehensive Evaluation of Underlying Diseases and Medications in Different Wards of a Large Urban Hospital Center in Iran. BMC Anesthesiology, 22, Article No. 147. [Google Scholar] [CrossRef] [PubMed]
[38] Burton, J.K., Craig, L.E., Yong, S.Q., Siddiqi, N., Teale, E.A., Woodhouse, R., Barugh, A.J., Shepherd, A.M., Brunton, A., Freeman, S.C., Sutton, A.J. and Quinn, T.J. (2021) Non-Pharmacological Interventions for Preventing Delirium in Hospitalised Non-ICU Patients. The Cochrane Database of Systematic Reviews, 7, CD013307. [Google Scholar] [CrossRef
[39] 徐永青, 刘玲. 集束化护理方案对无抽搐电休克治疗后谵妄的影响[J]. 四川精神卫生精, 2021, 34(3): 243-246.
[40] 关欣, 王斗, 邵欣. 我国187家医院ICU护士谵妄知识掌握与谵妄管理开展现况的调查分析[J]. 中华现代护理杂志, 2019, 25(24): 3138-3141. [Google Scholar] [CrossRef
[41] Davis, D., Searle, S.D. and Tsui, A. (2019) The Scottish Intercollegiate Guidelines Network: Risk Reduction and Management of Delirium. Age and Ageing, 48, 485-488. [Google Scholar] [CrossRef] [PubMed]
[42] Peden, C.J., Miller, T.R., Deiner, S.G., Eckenhoff, R.G., Fleisher, L.A. and Members of the Perioperative Brain Health Expert Panel (2021) Improving Perioperative Brain Health: An Expert Consensus Review of Key Actions for the Perioperative Care Team. British Journal of Anaesthesia, 126, 423-432. [Google Scholar] [CrossRef] [PubMed]