Postoperative mental abnormality

For people who have just undergone surgery, it will be very difficult to recover from the traumatic area, and the pain will be very severe after the operation. They will still be in a weak state and on the verge of mental collapse, which will lead to a very unstable mental state and even sentimentality. They are very worried about relapse after the operation. Many people have abnormal mental states after surgery, so they should do appropriate prevention and care to avoid worsening of the condition.

reason

⒈ Patient’s own factors: It is generally believed that patients with unstable emotions and sentimentality are prone to acute mental disorders after surgery.

⒉ Surgical factors: The incidence of acute postoperative mental disorders in open heart surgery under extracorporeal circulation is much higher than that in other surgeries. The main reason is that extracorporeal circulation may cause cerebral embolism or cerebral hypoperfusion. In addition, the incidence of postoperative mental disorders is also high after neurosurgery, more traumatic thoracic and abdominal surgery, and hip replacement.

⒊Anesthetic factors: It is currently believed that there is no obvious correlation between anesthesia methods and postoperative mental disorders. However, extremely low concentrations of residual anesthetic drugs after surgery may affect neurological function. Anticholinesterase drugs such as scopolamine can interfere with the storage process of information in the brain, leading to memory impairment; propofol slightly reduces orientation, self-control and comprehension; ketamine has specific dual effects of inhibition and excitation on the central nervous system.

⒋ Perioperative management: Excessive blood pressure fluctuations, hypoxemia, hyperventilation, blood loss or extreme hemodilution during surgery affect cerebral blood flow and oxygen supply, and have a direct or indirect impact on postoperative mental disorders. In addition, postoperative pain and changes in sleep cycles are also triggers of acute postoperative mental disorders.

examine

Brain dysfunction occurs after surgery, mainly manifested in impaired consciousness, cognitive impairment and psychomotor abnormalities.

Postoperative symptoms include apathy, nightmares, hallucinations, delirium and other adverse mental reactions

Differential Diagnosis

Differential diagnosis of acute postoperative psychiatric disorders:

1. Brain organic mental disorders: Brain organic mental disorders refer to mental disorders caused by brain infection, degeneration, vascular disease, trauma, tumor and other lesions, also known as brain organic psychosis. As human life expectancy increases, the elderly population gradually increases, and the incidence of organic brain disorders also increases significantly.

2. Organic mental disorder: Organic mental disorder is a group of mental disorders based on verifiable brain disease, brain damage or other damage as the cause. Mental disorders can be primary, such as diseases, injuries and damage that directly and selectively affect the brain; or they can be secondary, such as certain systemic diseases and disorders, in which the brain is only one of multiple organs or systems affected. The term symptomatic mental disorders refers to the latter subgroup. See: organic psychiatric syndrome.

3. Mental disorders caused by psychoactive substances: Mental disorders related to psychoactive substances (referred to as substances) can be divided into two categories: one is psychoactive substance use disorder (substance dependence disorder and substance abuse), and the other is disorders caused by psychoactive substances, including: psychoactive substance poisoning, psychoactive substance withdrawal reaction, psychoactive substance-induced delirium, persistent dementia caused by psychoactive substances, persistent amnesia disorder caused by psychoactive substances, psychotic disorders caused by psychoactive substances, mood disorders caused by psychoactive substances, anxiety disorders caused by psychoactive substances, sexual dysfunction caused by psychoactive substances and sleep disorders caused by psychoactive substances.

4. Mental disorders caused by non-dependent substances: Mental disorders caused by non-dependent substances (mentaldsordersusedbynn-ependentsbstances). Certain non-dependent substances such as hormones, isoniazid, benzene, organophosphorus, etc. come from outside the body. Although they do not produce psychological or physiological dependence, they can affect the individual's mental state and produce psychotic symptoms, which are often confused with schizophrenia.