死亡后器官捐献供肾移植术后患者躁狂性精神障碍的临床分析  

Manic mental disorder after kidney transplantation among deceased donation

作　　者：钟金彪 唐亮[1] 朱道方[1] 廖贵益[1] Zhong Jinbiao;Tang Liang;Zhu Daofang;Liao Guiyi(Department of Urology,the First Affiliated Hospital of Anhui Medical University,Hefei 230031,China)

机构地区：[1]安徽医科大学第一附属医院泌尿外科,合肥230031

出　　处：《国际移植与血液净化杂志》2020年第2期12-15,共4页International Journal of Transplantation and Hemopurification

基　　金：国家自然科学基金(81470986)。

摘　　要：目的探讨死亡后器官捐献(DD)供肾移植术后患者躁狂性精神障碍的临床特征、病因及防治。方法回顾性分析11例DD供肾移植术后躁狂性精神障碍患者的临床资料。5例症状较轻患者给予约束带约束四肢。余6例患者均应用镇静药物治疗,3例应用地西泮静脉推注,3例应用地西泮静脉推注加氟哌啶醇、异丙嗪肌肉注射,1例应用上述三种药物仍不能控制,转入重症监护室(ICU)气管插管,持续镇静。结果5例症状较轻者予约束带约束四肢后48 h内症状自行消失。4例应用镇静药物后症状逐渐消失,其中1例在治疗期间出现嗜睡。1例患者活动剧烈,短时间内地西泮、氟哌啶醇、异丙嗪均不能控制症状,突发移植肾破裂,切除移植肾。1例患者症状反复,最终地西泮、氟哌啶醇、异丙嗪效果均不佳,转入ICU气管插管持续镇静,2 d后拔除气管插管,意识良好,转回普通病房。结论DD供肾移植术后患者躁狂性精神障碍是多种因素综合作用的结果,可直接影响患者预后,对其及时进行适当治疗尤为重要。Objective To investigate the clinical features,etiology,prevention and treatment of manic mental disorder after kidney transplantation among deceased donation(DD).Methods We reviewed and analyzed clinical data of 11 patients with manic mental disorder after DD kidney transplantation.Five patients with mild symptoms were treated with restraint bands.All the remaining 6 patients were treated with sedatives.Diazepam was used in 3 cases,the other 3 cases were treated with diazepam and intramuscular injection of haloperidol and promethazine.One patient was transferred to ICU with endotracheal intubation and continued sedation after the application of the above three drugs.Results In the 5 cases with mild symptoms,the symptoms disappeared automatically within 48 hours after the restraint was applied to the limbs.In 4 patients,symptoms gradually disappeared after sedatives were applied,and one patient developed lethargy during treatment.One patient was active and could not control the symptoms for a short time with zepam,haloperidol and promethazine.The transplanted kidney was suddenly ruptured and the transplanted kidney was removed.One patient had repeated symptoms,and the results of diazepam,haloperidol and promethazine were not satisfactory.The patient was transferred to ICU for endotracheal intubation and continued sedation,and the endotracheal intubation was removed 2 days later.The patient was in good consciousness and transferred back to the general ward.Conclusions Manic mental disorder after DD kidney transplantation is the result of multiple factors,which can directly affect the prognosis of the patients,and is particularly important for timely and appropriate treatment.

关 键 词：死亡后器官捐献 肾移植 精神障碍 

分 类 号：R699[医药卫生—泌尿科学]