奥氮平治疗急性谵妄的临床疗效观察(1)
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2010年5月1日
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【摘要】目的:研究奥氮平对伴有严重精神症状的急性谵妄患者的临床疗效。方法:76例确诊为急性谵妄的患者随机分为两组,治疗组39人和对照组37人。在积极治疗原发病的同时,治疗组患者合并使用奥氮平治疗,对照组患者合并使用地西泮治疗。于治疗前,治疗2周,4周后分别使用谵妄评定量表(CAM-CR),临床总体印象量表(CGI)和药物副作用量表给予评分。结果:与治疗前相比,研究组在治疗2周后的CAM-CR和CGI量表评分有明显改善(P<0.05),而对照组改善不明显,有的患者症状加重。经过4周治疗后,研究组患者改善更明显(P<0.01),而对照组亦有明显改善(P<0.01),其中对照组有2例患者死亡。研究组与对照组的药物副作用量表评分无明显差异(P>0.05)。结论:奥氮平对于快速治疗急性谵妄患者有较好的疗效。
【关键词】奥氮平;急性谵妄;临床疗效观察
doi:10.3969/j.issn.1006-1959.2010.05.020 文章编号:1006-1959(2010)-05-1049-03
Olanzapine Treatment of Acute Delirium in Psychiatric Symptoms Associated with Clinical Efficacy SHI Hai-shan,ZHEN Dong
【Abstract】Objective: To study of olanzapine treatment of acute delirium in severity psychiatric symptoms associated with clinical efficacy.Methods:76 patients were diagnosed as acute delirium patients were randomly divided into two groups,the treatment group 39 and the control group 37.In the active treatment of primary disease, while the treatment group of patients olanzapine combination therapy,patients in the control group combined with diazepam treatment.In the treatment of pre-treatment 2 weeks,4 weeks respectively after using the delirium rating scale (CAM-CR),Clinical Global Impression Scale (CGI) and drug side effects rating scale given.Results:Compared with those before treatment,the Study Group in the treatment of 2 weeks after the CAM-CR and the CGI Scale score significantly improved (P <0.05),while the control group,no obvious improvement,and some patient's symptoms increased.After 4 weeks of treatment,the study group of patients improved more significantly (P <0.01),while the control group also improved significantly (P <0.01),in which the control group,2 patients died.Study group and control group of drug side effects rating scale was no significant difference (P> 0.05).Conclusion:Olanzapine for rapid treatment of acute delirium patients have a better effect.
【Key words】Acute delirium;Olanzapine;Clinical observation
谵妄是以意识、知觉、记忆、行为、人格改变为特征的脑器质性精神综合征。谵妄起病突然,一般从几小时到几天,病情是波动的,有不规则的间歇期,症状常有昼轻夜重的特点。主要特点是患者的精神与行为突然变化,常伴有情绪与思维方式的改变,患者谵妄期与清醒期常交替出现。对谵妄进行药物治疗的目的是镇静、控制精神障碍患者所用剂量;避免使用长效镇静剂和可能导致谵妄加重的药物。本研究使用奥氮平治疗急性谵妄患者,并与地西泮作对照,现报到如下:
1.资料与方法
1.1 一般资料:2007年1月至2009年10月,在广州市脑科医院神经内科住院的诊断为急性谵妄的76例患者,所有病例均符合DSM-Ⅱ(1980)制定的谵妄诊断标准 ......
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