Xylopia refers to a state of high psychomotor inhibition. There is usually no impairment of consciousness and various reflexes are preserved. After the release of the rigor mortis, the patient can recall what happened during the rigor mortis.
I. Treatment principles
1, symptomatic treatment as soon as possible to determine the cause of xylophobia, and then for the cause or different types of xylophobia to take appropriate treatment.
(1) Tension stiffness, the best way to release is electroconvulsive therapy. If the patient is not suitable for electroconvulsive therapy, intravenous sulpiride 200-400mg/day can be used.
(2) Depressive lignocaine, the best way to relieve it is also electroconvulsive therapy. Antidepressants should be given when the patient can be given orally.
(3) Psychogenic lignocaine, which can be relieved by itself and usually does not require special treatment, can also be given benzodiazepines or small doses of antipsychotics with sedative effect. (4) Organic wood stiffness: treatment of different organic causes, such as anti-infection, surgical removal of tumors or hematomas, etc.
2. Supportive therapy: Patients with xylosis have much difficulty in eating, so they need to be placed with a gastric tube from which fluids and nutrition are supplemented.
II. Nursing assessment
1.Assessment of subjective and objective information
(1) Ask the informant about the situation before and after the onset of the disease, and resuscitate the patient first if emergency treatment is needed. It is necessary to assess the time of onset, process, urgency of onset, temperature, blood pressure, pulse, respiration, pupil limb movement and neurological examination, and laboratory tests.
(2) Assessment of possible causes: catatonic, psychogenic, depressive, and organic rigor mortis. (3) Associated factors, such as: risk of aspiration by mistake, risk of injury, risk of impulsivity, risk of nutritional deficiency, risk of infection, risk of disuse syndrome, electrolyte disturbance, hypo volition or lack thereof.
2.Common mental disorders associated with xylophobia
(1) Schizophrenia, such as catatonic xylophobia.
(2) Mood disorders, such as depressive wood stiffness.
(3) Severe stress disorder, such as reactive wood stiffness, often accompanied by blurred consciousness. This state is short-lived and can be rapidly recovered or converted to an aroused state. After recovery, the experiences during the period of rigor mortis are mostly not recalled.
(4) Organic rigidity is commonly associated with: infections, such as type B encephalitis and sporadic viral encephalitis; toxicities, such as carbon monoxide toxic encephalopathy; brain tumors, such as tumors of the superior brainstem and third ventricle; cerebrovascular disease, such as subarachnoid hemorrhage; traumatic brain injury, such as subdural hematoma and intracranial hematoma; degenerative brain diseases, such as hepatomegaly; and epilepsy. Identification of organic xerostomia relies mainly on: a history of poisoning, infection, hypoxia, epilepsy, cerebrovascular disease or traumatic brain injury; impaired consciousness or seizures during the course of the disease; positive signs found on physical examination, especially neurological examination; and positive laboratory or special tests seen.
(5) Drug-induced lignocaine is called pharmacogenic lignocaine.
III. Nursing goals
The patient’s vital signs remain stable, vital organs are protected from damage, and no complications occur. The patient’s vital signs remain stable, vital organs are not damaged, and no complications occur.
IV. Nursing measures
1. Safety and life care
(1) Patients who are not able to take care of themselves need to be taken care of.
(2) Strengthen observation to prevent sudden excitement and injury to others.
(3) Ensure the patient’s nutrition and fluid intake. If the patient can accept feeding, he should be fed patiently; for those who refuse food completely, nasal feeding should be used, and nasal food should ensure sufficient protein, calories and vitamins. Maintain the balance of water, electrolytes and energy metabolism.
(4) Most of the consciousness of the patients with wood stiffness is clear, the words and behaviors of the medical staff in front of the patients must be paid attention to and should avoid stimulating the patients.
2.Special care
(1) Strengthen life care, pay attention to oral hygiene and avoid ulcers. Pay attention to the prevention of complications and regular turning to prevent the formation of bedsores. Do the second stool care, pay attention to defecation, catheterization and enema when necessary.
(2) Keep the respiratory tract unobstructed, do oral care, and adopt a recumbent position with the head tilted to one side.
(3) Cooperate with the doctor for ECT if necessary, and pay attention to the treatment effect and adverse reactions.
(4) Patients with catatonia may suddenly experience violent excitement or impulsive behavior, so it is necessary to strengthen precautions to prevent patients from self-injury and injury.
(5) It is important to prevent other patients from attacking or injuring the xylophobic patient.