Когнитивные и эмоциональные нарушения и возможности их коррекции в анестезиологическом обеспечении кардиохирургических операций
Практикующему анестезиологу-реаниматологу необходимо знать, что опасность когнитивных нарушений в раннем послеоперационном периоде заключается в несоответствии внешней «адекватности» пациента и возможности совершения им внезапных немотивированных, зачастую фатальных, поступков: невыполнение (забывание) рекомендаций персонала, вставание с кровати, удаление систем жизнеобеспечения (венозных… Читать ещё >
Содержание
- Список сокращений
Глава 1. Периоперационные когнитивные и эмоциональные 10 нарушения у кардиохирургических больных как медико-социальная проблема (обзор литературы)
1.1. Терминология и актуальность проблемы
1.2. Клиническая картина и дифференциальный диагноз
1.3. Характеристика периоперационных факторов риска
1.3.1. Предоперационные факторы риска
1.3.2. Интраоперационные факторы риска
1.3.3. Послеоперационные факторы риска
1.4. Церебропротекция у кардиохирургических пациентов
Глава 2. Материал и методы исследования
2.1. Организация исследования
2.2. Критерии включения в исследование пациентов
2.3. Группы пациентов и их характеристика 36
2.4. Изучение показателей эмоциональной сферы у здоровых лиц
2.5. Предоперационная подготовка
2.6. Интраоперационный период
2.7. Послеоперационный период
2.8. Методика коррекции послеоперационных когнитивных и эмо- 48 циональных расстройств с использованием лидокаина
2.9. Методика коррекции послеоперационных интеллектуальных и 49 эмоциональных нарушений с использованием инстенона
2.10. Методика коррекции послеоперационных эмоциональных и 49 когнитивных расстройств с привлечением близких и родственников пациентов
2.11. Этапы исследования
2.12. Экспериментальное психологическое исследование
2.13. Нейропсихологическое исследование
2.14. Оценка качества жизни
2.15. Статистическая обработка результатов
Глава 3. Результаты исследования 56 3.1. Общая оценка периоперационных эмоциональных и когнитив- 56 ных расстройств
3.1.1. Результаты исследования эмоциональной сферы
3.1.1.1. Результаты изучения уровня астении
3.1.1.2. Результаты изучения уровня депрессии
3.1.1.3. Результаты изучения уровня ситуационной тревожности
3.1.1.4. Результаты изучения уровня личностной тревожности
3.1.2. Исследование познавательной сферы обследуемых пациентов
3.2. Исследование качества жизни обследуемых пациентов
3.2.1. Результаты изучения общего показателя качества жизни
3.2.2. Результаты изучения показателей работоспособности
3.2.3. Результаты изучения показателей социальной устроенности
3.2.4.Результаты изучения показателей общего состояния здоровья
3.3. Выявление основных факторов риска развития эмоциональных 63 и когнитивных нарушений
3.3.1. Результаты изучения дооперационных факторов риска
3.3.2.Результаты изучения интраоперационных факторов риска
3.3.3. Результаты изучения послеоперационных факторов риска
3.4. Результаты поиска прогностических критериев формирования 93 когнитивных и эмоциональных нарушений
Глава 4. Обсуждение результатов исследования
4.1. Общая характеристика результатов
4.2. Анализ дооперационных факторов риска
4.3. Анализ интраоперационных факторов риска
4.4. Анализ послеоперационных факторов риска
4.5. Анализ взаимосвязи когнитивных и эмоциональных нарушений
4.6. Анализ взаимосвязи системы ЕигоБССЖЕ с периоперационны- 108 ми эмоциональными и когнитивными нарушениями
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