Zvinokonzera, Zviitiko Zvengozi, Kuongororwa nekurapwa kweDeliriamu
Overview
Varwere vakawanda vanovhiringidzika mushure mekuvhiyiwa, asi delirium rudzi rwakasiyana rwekuvhiringidzika kunogona kuitika muchipatara uye panguva yekudzoka kubva pakuvhiyiwa . Kunyange zvazvo delirium inokonzera kuvhiringidzika, kusanganiswa kwose hakuna kukonzerwa ne delirium.
Deliriamu inzvimbo yekuvhiringidzika inoitika pakarepo. Inowanzova yakaoma mumasikirwo - akamboonekwa uye akarapwa, murwere anodzokera kumamiriro avo akaenzana ekufunga.
Murwere anokanganiswa zuva rega ega anonyanya kuvhiringidzika, uye munguva dzakawanda, achadzokera kumamiriro avo akazara ekuvhiringidzika mushure mokunge chirongwa chacho chagadziriswa.
Risk Factors
Kunyange zvazvo chero munhu aigona kukurudzira, mamwe mapoka akawanda anowanzoita kuti ave nechirwere muchipatara. Zera rinotanga basa, asi kusimba kwehutachiwana huno, hutano hwemazuva ose hwehutano hwehutano uye hutano hwemurwere hunoitawo chikamu.
- Vakwegura uye vakuru vakuru
- Vanhu vane chirwere chepfungwa, chirwere cheAlzheimer kana chimwe chirwere chehutano hwepfungwa chinoderedza kukwanisa kufunga zvakajeka kana kukonzera kuvhiringidzika
- Vanhu vane urombo
- Kurapa varwere
- VAKU varwere, varwere vanorwara
- Varwere vane nguva refu yekugara muchipatara
- Mamwe mishonga
Sezvaunogona kufungidzira, murwere akwegura ane chirwere chekuita nehutano chinoda kuomeswa kwakanyanya kune ngozi yakawandisa kupfuura wechidiki mukuru asina zvimwe zvinokonzera ngozi kune ari mune imwe nzvimbo muchipatara.
Kunyatsochengetedza zviyero zvinyorwa , kunyanya, zvinokanganisa zvakanyanya kurara zvakakwana / kwemaitiro, sezvo varwere vari kutarisana nezviratidzo zvinowanzokosha, mishonga nguva dzose, vanowanzoshandurwa, vari kuwana mamwe mishonga uye vanowanzowanikwa mudzimba dzinopenya zvakapoteredza nguva . Munzvimbo iyo unogona kunzwa delirium inonzi "ICU Psychosis."
Iyo inowanzoonekwa kune vakwegura vakuru uye vakwegura asi inogona kuitika mune rimwe boka rezera. Izvo zvinowanzoonekwawo kune vanhu vane rumwe rudzi rwehutano hwepfungwa muupenyu hwavo hwezuva nezuva, dzakadai sedhementia.
Vaya vakwegura vane chirwere chekuita nehutano hwemhetambo vane dambudziko guru rekuwirwa nekuderera kwepfungwa dzavo pavanenge vari muchipatara.
Zviratidzo zvekutanga
Pamberi murwere anotanga kuratidzira zviratidzo zve delirium, kune imwe nzvimbo yapfuura iyo varwere vanogona kutora maawa kana kunyange mazuva apfuura. Munguva ino, varwere vanogona kurondedzera kurota kwakanyatsojeka, kuoma kurara, kuwedzera kwekutya kana kushungurudzika kwakanga kusipo, uye kungatanga kukumbira kuvepo kweimwe nguva muimba yavo.
Kuisa zviratidzo izvi kare kunogona kureva kupindira kwepakutanga uye kunogona kudzivirira murwere kuti awane chirwere chakakwana mumazuva anotevera.
Zviratidzo
Hapana chiyero chekurima, hachigoni kuonekwa kuburikidza nebasa rebazi, rinofanira kuongororwa nekucherechedza mararamiro omurwere nekugadzirisa kana mufambiro wavo unofanirwa kuongororwa kwe delirium.
Kuongorora chirandi kunogona kunge kwakaoma sezvo zvingave zvakasiyana zvikuru nekushivirira kusvika murwere.
Muzhinji, vanhu vane delirium vangave vakaomerwa kuisa pfungwa pane imwe nyaya, kazhinji vanoita sevasingafadzi uye vanowanzova nehuwandu hwekuziva.
Kushungurudzika kwavo uye zvinetso zvepfungwa zvinowanzowedzera husiku usiku, mamiriro ezvinhu anonzi "vanodya zuva" kana kuti "kuvira kwezuva".
Hluccinations and Delusions
Ivava vanhu vanogona kuve nekunyengedzwa nekufungidzira. Kushungurudzika ndeyekutenda kwenhema kunoitwa nomunhu. Semuenzaniso, murwere ane delirium angatenda kuti mukoti ari kuedza kuvauraya, kana zvipembenene zviri kuputira mubhedha wavo.
Hluccinations ishungurudzo chekuona. Murwere anogona kuona bhururu dzichibhururuka dzichipoteredza mukamuri uye dzinovona dzichibhururuka kubva pakona kusvika pakona. Vanogona kuedza uye vanoedza kubata chimwe chinhu chisipo, kana kutaura kune mumwe munhu asiripo kana kunyange munhu akafa.
Zviratidzo zvenyama
Panyama, murwere anowanzokwanisa kurara zvakanaka, uye angatanga kuoma nekugomera, achitaura nenzira inonzwisisika uye inonzwisisika, uye angatanga kutengesa pasina chikonzero chaicho.
Aya zviratidzo uye zviratidzo zvinofanira kutorwa seboka, kwete mumwe nomumwe. Munhu anenge anetseka kumedza angave asina delirium, asi murwere asingakwanisi kugara, asingagoni kumedza, ari kuona shiri muimba yechipatara uye asina kurara kwamazuva zvichida.
Aina
Deliriamu inogona kupa sechinopfurikidza chinyorwa che delirium kana kuti chinonyanya kushandiswa. Hyperactive delirium inokonzera kushungurudzika, murwere angave akazuka akasvinura kusvika pakuguma kwekusagona kurara kwemazuva, uye zvingaita sekuti vari pakakwirira. Vangaita sokuti "vakuvadzwa" kana kusazorora, sekunge vakave nehafini yakawanda yekurara. Izvi zvinowanzoshamisika mumamiriro ezvinhu ekuchengetwa kwavo mutirwere - ivo vakasvinura apo mumwe munhu angatarisirwa kuda kuzorora zvakakwana.
Hypoactive delirium varwere vanogona kunge vachiita sevanokurudzira, vakaneta kuti vasaregerera basa, vakaora mwoyo, vakarara, uye vangasazokwanisa kutaura. Izvi zvinowanzova zvakaoma kusiyanisa kubva kurwara uye kuneta kudarika rudzi rwakawanda.
Chikonzero nei Zvakanyanya Kuwirirana Pashure Pokuvhiya
Delirium inoonekwa kakawanda mukuvhiya varwere kupfuura huwandu hwehuwandu hwechipatara nekuda kwezvikonzero zvakasiyana, vanowanzove varwara kudarika zviyero, vanowana mishonga yeanesthesia iyo inogona kuunza kudii, inogona kuva nechipatara kwenguva refu uye inogona kuwana mishonga inorwadza panguva kupora kwavo uye mamwe mishonga inogona kukuvadza delirium.
Kurapa
Kunze kwekubatsira murwere kuwana hutano hwakanaka hwavanoda kwazvo, varwere vane delirium vachadawo rubatsiro kutarisira zvinhu zvinokosha uye zvinokosha zvavasingakwanise kuita kana vachirwara.
Apo murwere ane chirrium, zvakakosha kuti vashandi vechipatara (pamwe nemhuri uye neshamwari vanogona kushanyira) vanobatsira kupa murwere zvinhu zvinokosha zvavanoda zvikuru. Izvi zvinosanganisira kurara kusina kunetseka, kudya uye kunwa nguva dzose, kutarisira zvigadziro zvekugezera nekugara uchigadzirisa chirwere chinokanganiswa.
Kuramba uchidzokorora kunoreva kungoita kuti murwere azive kuti vari muchipatara, nei vachiripo uye zuva ripi uye nguva ipi. Kune mhuri neshamwari, zvakakosha kuti usapopotedzana nemurwere uyo akavhiringidzika kana kuti anonzwa kudengenyeka kana kukanganisa. Iwe unogona kuedza zvinyoronyoro kugadzirisa murwere kune kwavari uye nei, asi kukakavara kuchagumbura murwere uye nhengo yemhuri.
Zvakakoshawo kuti musamutse murwere pavanenge vakarara kunze kwekuti zvakakosha, uye vashandi vangasarudza kurega chiratidzo chinokosha chekutarisa kana pakati peusiku mishonga inogona kumirira kusvika mangwanani kana zvinoreva kurega murwere kurara. Zvimwe zvivako zvinopa mavhaplugs uye masikisi emaziso kune varwere kuitira kuti vawedzere kunaka kwavo kwehope nekudzima kunze kwechiedza chenguva dzose uye ruzha.
Kana murwere asingakwanisi kuvimbwa kuti ave oga asina kukuvadzwa nekuda kwekubuda pamubhedha kana mamwe mabasa, mhuri, shamwari, kana vashandi vanogona kunge vari muimba nguva dzose.
Mishonga
Kuziva chikonzero chinokonzera delirium chinhu chinokosha pakurapa. Kana mushonga uri kukonzera dambudziko, rega. Kana kurega kunwa doro , zvinodhaka zvinodhaka kana mishonga ndiyo dambudziko, ritore. Kana kukanganisa kurara kwakanyanya ndiko kukonzera, kurapwa kunosanganisira kugovera nzvimbo yakanakisisa inoita kuti kurara nemishonga kukurudzira kurara.
Chirongwa chepachirwere chokurara, zvakadai saRamelteon (Rozerem), anowanzopiwa kuti zvive nyore kurara , asi mamwe mishonga yakadai seAtivan inogona kugoverwa kuti kuderedze kushungurudzika uye chero zviratidzo zvinodzinga zvingave zviripo. Antipsychotic mishonga yakadai seHaldol uye Risperdal inogonawo kushandiswa, asi inofanira kupiwa mumadheka ekuderera kunogona kudzivirira kuwedzera kwekuvhiringidzika kwomurwere.
Kunobva:
Postoperative Delirium muVakuru: kurapwa uye kutungamirirwa. Mishonga yeKliniki Mukukwegura. Thomas Robinson naBen Eiseman. Yakasvika munaJanuary 2015. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2546478/