2 research outputs found
Π‘ΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΡΠΉ Π²Π·Π³Π»ΡΠ΄ Π½Π° ΠΏΡΠΎΠ±Π»Π΅ΠΌΡ ΠΎΡΡΡΠΎΠ³ΠΎ ΠΏΠΎΡΠ»Π΅ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΎΠ½Π½ΠΎΠ³ΠΎ Π΄Π΅Π»ΠΈΡΠΈΡ Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² ΡΡΠ°Π²ΠΌΠ°ΡΠΎΠ»ΠΎΠ³ΠΎ-ΠΎΡΡΠΎΠΏΠ΅Π΄ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΏΡΠΎΡΠΈΠ»Ρ Π² ΡΡΠ»ΠΎΠ²ΠΈΡΡ ΠΎΡΠ΄Π΅Π»Π΅Π½ΠΈΡ ΡΠ΅Π°Π½ΠΈΠΌΠ°ΡΠΈΠΈ ΠΈ ΠΈΠ½ΡΠ΅Π½ΡΠΈΠ²Π½ΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ
The purpose of the present literature review is a systematization of known evidence on the problem of postoperative delirium as a frequent complication in elderly and senile patients during extensive reconstructiveΒ surgery on the spine and large joints. The review, which is based on publications of foreign and native authors, provides insights into current understanding of the pathogenesis, risk factors, diagnosis, methods of treatment, and prevention of these complications. The number of operations in traumatology and orthopedy is increasing. Accordingly with this fact, we are seeing an increase the number of cases of postoperative delirium. We know that the risk of delirium is linked with patient age. The interest to this problem is growing and has clinical and economical background. The etiology of delirium is considered to be multivariate. The development of diagnostic tools is playing a very important role and provides control of delirium in intensive care unit. Common understanding of this stateβs pathophysiology and the opportunity to participate another physician leads to correct organization of treatment process. The knowledge of acute postoperative delirium in intensive care unit is being formed. The basic concept of postoperative delirium varies from its definition psychiatry and narcology due to differences in how different specialties treat the disorder. The risk factors of treatment are estimated. The controlled sedation is a clear trend. The experience of practical application dexmedetomidin for prevention and treatment of postoperative delirium is accumulated. Although the value of drug- therapy is difficult to overestimate the great influence on the result have non- pharmalogical methods.Π¦Π΅Π»Ρ ΠΏΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½Π½ΠΎΠ³ΠΎ ΠΎΠ±Π·ΠΎΡΠ° Π»ΠΈΡΠ΅ΡΠ°ΡΡΡΡ β ΡΠΈΡΡΠ΅ΠΌΠ°ΡΠΈΠ·Π°ΡΠΈΡ ΠΈΠ·Π²Π΅ΡΡΠ½ΡΡ
ΡΠ²Π΅Π΄Π΅Π½ΠΈΠΉ ΠΏΠΎ ΠΏΡΠΎΠ±Π»Π΅ΠΌΠ΅ ΠΏΠΎΡΠ»Π΅ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΎΠ½Π½ΠΎΠ³ΠΎ Π΄Π΅Π»ΠΈΡΠΈΡ ΠΊΠ°ΠΊ ΡΠ°ΡΡΠΎΠ³ΠΎ ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΡ Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² ΠΏΠΎΠΆΠΈΠ»ΠΎΠ³ΠΎ ΠΈ ΡΡΠ°ΡΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π²ΠΎΠ·ΡΠ°ΡΡΠ° ΠΏΡΠΈ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ΠΈΠΈ ΠΎΠ±ΡΠΈΡΠ½ΡΡ
ΡΠ΅ΠΊΠΎΠ½ΡΡΡΡΠΊΡΠΈΠ²Π½ΡΡ
Ρ
ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΉ Π½Π° ΠΏΠΎΠ·Π²ΠΎΠ½ΠΎΡΠ½ΠΈΠΊΠ΅ ΠΈ ΠΊΡΡΠΏΠ½ΡΡ
ΡΡΡΡΠ°Π²Π°Ρ
. Π ΠΎΠ±Π·ΠΎΡΠ΅, ΠΎΡΠ½ΠΎΠ²Π°Π½Π½ΠΎΠΌ Π½Π° ΠΏΡΠ±Π»ΠΈΠΊΠ°ΡΠΈΡΡ
Π·Π°ΡΡΠ±Π΅ΠΆΠ½ΡΡ
ΠΈ ΠΎΡΠ΅ΡΠ΅ΡΡΠ²Π΅Π½Π½ΡΡ
Π°Π²ΡΠΎΡΠΎΠ², ΠΏΡΠΈΠ²ΠΎΠ΄ΡΡΡΡ ΡΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΡΠ΅ ΠΏΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½ΠΈΡ ΠΎ ΠΏΠ°ΡΠΎΠ³Π΅Π½Π΅Π·Π΅, ΡΠ°ΠΊΡΠΎΡΠ°Ρ
ΡΠΈΡΠΊΠ°, Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠ΅, ΠΌΠ΅ΡΠΎΠ΄Π°Ρ
Π»Π΅ΡΠ΅Π½ΠΈΡ ΠΈ ΠΏΡΠΎΡΠΈΠ»Π°ΠΊΡΠΈΠΊΠ΅ ΡΡΠΎΠ³ΠΎ ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΡ. ΠΡΠ΅Π²ΠΈΠ΄Π½ΠΎ, ΡΡΠΎ ΠΏΠΎΠ²ΡΡΠ΅Π½ΠΈΠ΅ ΡΠΈΡΠ»Π° ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΉ Π² ΡΡΠ°Π²ΠΌΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΠΈ ΠΈ ΠΎΡΡΠΎΠΏΠ΅Π΄ΠΈΠΈ ΡΠΎΠΏΡΠΎΠ²ΠΎΠΆΠ΄Π°Π΅ΡΡΡ ΡΠ²Π΅Π»ΠΈΡΠ΅Π½ΠΈΠ΅ΠΌ ΡΠΈΡΠΊΠ° Π²ΠΎΠ·Π½ΠΈΠΊΠ½ΠΎΠ²Π΅Π½ΠΈΡ ΠΏΠΎΡΠ»Π΅ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΎΠ½Π½ΠΎΠ³ΠΎ Π΄Π΅Π»ΠΈΡΠΈΡ. Π ΡΡΠΎΡ ΡΠΈΡΠΊ ΡΠ²ΡΠ·Π°Π½ Π² ΠΏΠ΅ΡΠ²ΡΡ ΠΎΡΠ΅ΡΠ΅Π΄Ρ Ρ Π²ΠΎΠ·ΡΠ°ΡΡΠ½ΡΠΌ ΡΠΎΡΡΠ°Π²ΠΎΠΌ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ². ΠΠΎΠ·ΡΠ°ΡΡΠ°ΡΡΠΈΠΉ ΠΈΠ½ΡΠ΅ΡΠ΅Ρ ΠΊ ΡΡΠΎΠΉ ΠΏΡΠΎΠ±Π»Π΅ΠΌΠ°ΡΠΈΠΊΠ΅ ΠΈΠΌΠ΅Π΅Ρ ΠΊΡΠΎΠΌΠ΅ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π·Π½Π°ΡΠ΅Π½ΠΈΡ ΠΈ ΡΠ΅ΡΠΊΠΈΠ΅ ΡΠΊΠΎΠ½ΠΎΠΌΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΠΏΡΠ΅Π΄ΠΏΠΎΡΡΠ»ΠΊΠΈ. Π Π½Π°ΡΡΠΎΡΡΠ΅Π΅ Π²ΡΠ΅ΠΌΡ ΡΡΠΈΡΠ°Π΅ΡΡΡ, ΡΡΠΎ ΡΡΠΈΠΎΠ»ΠΎΠ³ΠΈΡ ΡΠ°Π·Π²ΠΈΡΠΈΡ Π΄Π΅Π»ΠΈΡΠΈΡ β ΠΌΠ½ΠΎΠ³ΠΎΡΠ°ΠΊΡΠΎΡΠ½Π°Ρ. ΠΡΠΊΠ»ΡΡΠΈΡΠ΅Π»ΡΠ½ΠΎ Π²Π°ΠΆΠ½ΡΡ ΡΠΎΠ»Ρ ΠΈΠ³ΡΠ°Π΅Ρ ΡΠΎΠ·Π΄Π°Π½ΠΈΠ΅ ΠΈΠ½ΡΡΡΡΠΌΠ΅Π½ΡΠΎΠ² Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠΈ ΠΏΠΎΡΠ»Π΅ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΎΠ½Π½ΠΎΠ³ΠΎ Π΄Π΅Π»ΠΈΡΠΈΡ, ΡΡΠΎ ΠΎΠ±Π΅ΡΠΏΠ΅ΡΠΈΠ»ΠΎ Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎΡΡΡ ΡΠ΅Π»Π΅Π²ΠΎΠ³ΠΎ ΠΊΠΎΠ½ΡΡΠΎΠ»Ρ ΡΡΠΎΠ³ΠΎ ΡΠΎΡΡΠΎΡΠ½ΠΈΡ Π² ΡΡΠ»ΠΎΠ²ΠΈΡΡ
ΠΎΡΠ΄Π΅Π»Π΅Π½ΠΈΡ ΠΈΠ½ΡΠ΅Π½ΡΠΈΠ²Π½ΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ. ΠΡΠ°Π²ΠΈΠ»ΡΠ½Π°Ρ ΠΎΡΠ³Π°Π½ΠΈΠ·Π°ΡΠΈΡ Π»Π΅ΡΠ΅Π±Π½ΠΎΠ³ΠΎ ΠΏΡΠΎΡΠ΅ΡΡΠ° ΠΏΠΎΠ΄ΡΠ°Π·ΡΠΌΠ΅Π²Π°Π΅Ρ Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎΡΡΡ ΡΡΠ°ΡΡΠΈΡ ΡΠΏΠ΅ΡΠΈΠ°Π»ΠΈΡΡΠΎΠ² ΡΠ°Π·Π»ΠΈΡΠ½ΡΡ
ΠΏΡΠΎΡΠΈΠ»Π΅ΠΉ Π½Π° ΠΎΡΠ½ΠΎΠ²Π΅ Π΅Π΄ΠΈΠ½ΡΡΠ²Π° ΠΏΠΎΠ½ΠΈΠΌΠ°Π½ΠΈΡ ΠΏΠ°ΡΠΎΡΠΈΠ·ΠΈΠΎΠ»ΠΎΠ³ΠΈΠΈ Π΄Π°Π½Π½ΠΎΠ³ΠΎ ΡΠΎΡΡΠΎΡΠ½ΠΈΡ. Π€ΠΎΡΠΌΠΈΡΡΠ΅ΡΡΡ ΠΎΠ±ΡΠ΅ΠΌ ΡΠΏΠ΅ΡΠΈΡΠΈΡΠ΅ΡΠΊΠΈΡ
Π·Π½Π°Π½ΠΈΠΉ ΠΈΠΌΠ΅Π½Π½ΠΎ ΠΎ ΠΏΠΎΡΠ»Π΅ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΎΠ½Π½ΠΎΠΌ Π΄Π΅Π»ΠΈΡΠΈΠΈ Π² ΠΎΡΠ΄Π΅Π»Π΅Π½ΠΈΠΈ ΠΈΠ½ΡΠ΅Π½ΡΠΈΠ²Π½ΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ. Π ΡΡΠ° Π΄Π΅ΡΠΈΠ½ΠΈΡΠΈΡ ΠΈΠΌΠ΅Π΅Ρ ΡΡΠ΄ ΠΎΡΠ»ΠΈΡΠΈΠΉ ΠΎΡ ΡΠΎΠ³ΠΎ, ΡΡΠΎ ΠΏΠΎΠ΄ΡΠ°Π·ΡΠΌΠ΅Π²Π°ΡΡ ΠΏΠΎΠ΄ ΡΠ΅ΡΠΌΠΈΠ½ΠΎΠΌ Β«Π΄Π΅Π»ΠΈΡΠΈΠΉΒ» Π² ΠΏΡΠΈΡ
ΠΈΠ°ΡΡΠΈΠΈ ΠΈ Π½Π°ΡΠΊΠΎΠ»ΠΎΠ³ΠΈΠΈ. Π‘ΠΎΠΎΡΠ²Π΅ΡΡΡΠ²Π΅Π½Π½ΠΎ ΡΡΠΈΠΌ ΠΏΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½ΠΈΡΠΌ ΡΠΎΡΠΌΠΈΡΡΡΡΡΡ ΠΌΠΎΠ΄Π΅Π»ΠΈ ΡΠ΅ΡΠ°ΠΏΠ΅Π²ΡΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΏΠΎΠ΄Ρ
ΠΎΠ΄ΠΎΠ². ΠΡΠ΅Π½Π΅Π½Ρ ΡΠΈΡΠΊΠΈ ΡΠ°ΠΌΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ. ΠΠ°ΠΌΠ΅ΡΠ΅Π½Π° ΡΠ΅ΡΠΊΠ°Ρ ΡΠ΅Π½Π΄Π΅Π½ΡΠΈΡ ΠΊ ΠΊΠΎΠ½ΡΡΠΎΠ»ΠΈΡΡΠ΅ΠΌΠΎΠΉ ΡΠ΅Π΄Π°ΡΠΈΠΈ. ΠΠ°ΠΊΠ°ΠΏΠ»ΠΈΠ²Π°Π΅ΡΡΡ ΠΎΠΏΡΡ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΡ ΡΠ°ΠΊΠΎΠ³ΠΎ ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠ°, ΠΊΠ°ΠΊ Π΄Π΅ΠΊΡΠΌΠ΅Π΄Π΅ΡΠΎΠΌΠΈΠ΄ΠΈΠ½, ΠΈΠ»ΠΈ Π΄Π΅ΠΊΡΠ΄ΠΎΡ, Π΄Π»Ρ ΠΏΡΠΎΡΠΈΠ»Π°ΠΊΡΠΈΠΊΠΈ ΠΈ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ Π΄Π΅Π»ΠΈΡΠΈΡ. ΠΠ°ΠΆΠ½ΠΎΡΡΡ ΠΌΠ΅Π΄ΠΈΠΊΠ°ΠΌΠ΅Π½ΡΠΎΠ·Π½ΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ Π΄Π΅Π»ΠΈΡΠΈΡ ΡΠ»ΠΎΠΆΠ½ΠΎ ΠΏΠ΅ΡΠ΅ΠΎΡΠ΅Π½ΠΈΡΡ, ΡΠ΅ΠΌ Π½Π΅ ΠΌΠ΅Π½Π΅Π΅ Π½Π΅ΠΌΠ΅Π΄ΠΈΠΊΠ°ΠΌΠ΅Π½ΡΠΎΠ·Π½ΡΠ΅ ΠΌΠ΅ΡΠΎΠ΄Ρ ΠΏΡΠΎΡΠΈΠ»Π°ΠΊΡΠΈΠΊΠΈ ΠΈ Π»Π΅ΡΠ΅Π½ΠΈΡ Π΄Π΅Π»ΠΈΡΠΈΡ ΡΠΎΡ
ΡΠ°Π½ΡΡΡ ΡΠ²ΠΎΡ Π·Π½Π°ΡΠΈΠΌΠΎΡΡΡ
Modern view on the problem of acute postoperative delirium in trauma and orthopedic patients in the intensive care unit
The purpose of the present literature review is a systematization of known evidence on the problem of postoperative delirium as a frequent complication in elderly and senile patients during extensive reconstructiveΒ surgery on the spine and large joints. The review, which is based on publications of foreign and native authors, provides insights into current understanding of the pathogenesis, risk factors, diagnosis, methods of treatment, and prevention of these complications. The number of operations in traumatology and orthopedy is increasing. Accordingly with this fact, we are seeing an increase the number of cases of postoperative delirium. We know that the risk of delirium is linked with patient age. The interest to this problem is growing and has clinical and economical background. The etiology of delirium is considered to be multivariate. The development of diagnostic tools is playing a very important role and provides control of delirium in intensive care unit. Common understanding of this stateβs pathophysiology and the opportunity to participate another physician leads to correct organization of treatment process. The knowledge of acute postoperative delirium in intensive care unit is being formed. The basic concept of postoperative delirium varies from its definition psychiatry and narcology due to differences in how different specialties treat the disorder. The risk factors of treatment are estimated. The controlled sedation is a clear trend. The experience of practical application dexmedetomidin for prevention and treatment of postoperative delirium is accumulated. Although the value of drug- therapy is difficult to overestimate the great influence on the result have non- pharmalogical methods