肾移植术后早期一过性精神异常的临床诊治

Clinical diagnosis and treatment of early transient psychosis after kidney transplantation

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DOI
刊名
Journal of International Psychiatry
年,卷(期) 2020, 47(3)
作者
作者单位

湖南省益阳市中心医院肾移植科 ;

摘要
【摘 要】目的:探讨临床诊治肾移植术后早期一过性精神异常的方法及效果。方法:回顾性分析2017年11月至2019年11月我院公民逝世后器官捐献肾移植术219例后出现早期一过性精神异常患者97例的临床资料。结果:97例患者中,用药后躁狂症状逐渐消失、能够对治疗进行安静配合97例(100.0%),期间呈嗜睡状态54例(55.7%),有呼吸伴鼾声出现、具有平稳的生命体征41例(42.3%)。24~48h后依据患者的实际病情将镇静药物剂量逐渐减少到停用,均没有躁狂症状再次出现、具有稳定的情绪。14~45d后痊愈出院97例(100%)。活动增多、焦躁不安对地西泮治疗无效者2例,改用丙泊酚对躁狂症状进行控制,24h后无症状2例(2.1%)。对患者进行3~27个月的随访,患者血肌酐水平63.1~205.7μmol/L,平均(98.4±10.3)μmol/L,均具有良好的肾脏功能,均没有精神症状再次出现。结论:综合诊治肾移植术后早期一过性精神异常能够有效改善患者预后。
Abstract
[Abstract] Objective: To explore the methods and effects of clinical diagnosis and treatment of early transient psychosis after renal transplantation. Methods: The clinical data of 18 cases of patients with transient psychosis after kidney transplantation from November 2017 to November 2019 were analyzed retrospectively. Results: Among the 97 patients, the manic symptoms gradually disappeared, 97 patients (100.0%) were able to cooperate with the treatment quietly, 54 patients (55.7%) were drowsy during the treatment, 41 patients (42.3%) had breathing accompanied by snoring and had stable vital signs. 24-48 hours later, the sedative dosage was gradually reduced to no use according to the actual condition of the patients, and there was no manic symptoms again, with stable mood. 97 cases (100%) were cured and discharged after 14-45 days. Two patients (2.1%) had no effect on diazepam treatment due to increased activity and restlessness. The patients were followed up for 3-27 months. The serum creatinine level of the patients was 63.1-205.7 μ mol / L, with an average of (98.4 ± 10.3) μ mol / L. all of them had good renal function and no mental symptoms appeared again. Conclusion: Comprehensive diagnosis and treatment of early transient psychosis after kidney transplantation can effectively improve the prognosis of patients.
关键词
【关键词】肾移植;术后早期;一过性精神异常;临床诊治
KeyWord
[Key words] Kidney transplantation; Early postoperative period; transient psychosis; Clinical diagnosis and treatment
基金项目
页码 514-516
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熊烈*. 肾移植术后早期一过性精神异常的临床诊治 [J]. 国际精神病学杂志. 2020; 47; (3). 514 - 516.

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