[1]吴传芹,朱艳萍,李国宏.ICU患者谵妄的发生率及危险因素分析[J].第三军医大学学报,2018,40(11):1038-1043.
 WU Chuanqin,ZHU Yanping,LI Guohong.Incidence and risk factors of delirium in ICU patients [J].J Third Mil Med Univ,2018,40(11):1038-1043.
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ICU患者谵妄的发生率及危险因素分析(/HTML )
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《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

卷:
40卷
期数:
2018年第11期
页码:
1038-1043
栏目:
临床医学
出版日期:
2018-06-15

文章信息/Info

Title:
Incidence and risk factors of delirium in ICU patients 
作者:
吴传芹朱艳萍李国宏
南京中医药大学护理学院;东南大学附属中大医院:重症医学科,护理部
Author(s):
WU Chuanqin ZHU Yanping LI Guohong

Nursing College, Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, 210023; ICU, Department of Nursing, Zhongda Hospital, Southeast University, Nanjing, Jiangsu Province, 210009, China

关键词:
谵妄危险因素ICU意识模糊评估法ICU患者
Keywords:
delirium risk factors Confusion Assessment Method in the Intensive Care Unit ICU patients  
分类号:
R181.32; R395; R741
文献标志码:
A
摘要:

目的    探讨重症监护室(intensive care unit, ICU)患者谵妄的发生情况及其相关危险因素。 方法    选择江苏省南京市东南大学附属中大医院重症医学科2016年3-9月收治的318名综合ICU患者,使用ICU意识模糊评估法(CAMICU),每8小时评估1次ICU患者是否发生谵妄,采用多元Logistic回归分析谵妄的危险因素。结果    86例患者因昏迷而无法使用CAMICU进行谵妄的评估,其余232例患者中95例发生ICU谵妄,ICU谵妄发生率为40.9%。其中48例(50.5%)患者谵妄首次发生时间在入院3 d内。ICU谵妄的分型:兴奋型谵妄24例,占25.5%;抑郁型谵妄25例,占26.6%;混合型谵妄45例,占47.9%。Logistic回归分析结果显示:≥65周岁、APACHE Ⅱ评分、因创伤入住ICU、酗酒史、高血压病史、代谢性酸中毒、呼吸系统疾病、使用咪达唑仑、使用机械通气是谵妄的独立危险因素(P<0.05)。 结论     ICU患者谵妄的发生率较高,年龄≥65周岁、APACHE Ⅱ评分高、因创伤入住ICU、有酗酒史和高血压病史、代谢性酸中毒、有呼吸系统疾病、使用咪达唑仑、使用机械通气的ICU患者易发生谵妄。

Abstract:

Objective    To explore the incidence and related risk factors of delirium in ICU patients. Methods    A total of 318 patients hospitalized in comprehensive ICU from Zhongda Hospital during March and September 2016 were enrolled in this study. Confusion Assessment Method in the Intensive Care Unit (CAM-ICU) was used to evaluate whether a delirium occurred in the ICU patients every 8 h. Logistic regression analysis was employed to screen the related risk factors for delirium. Results    There were 86 patients not being evaluated with CAM-ICU due to coma. In the remaining 232 ICU patients, 95 cases experienced delirium, with an incidence rate of 40.9%, and 48 cases (50.5%) patients had delirium for the first time within 3 days after admission. There were 24 cases having excited type of delirium (25.5%), 25 cases with depression type (26.6%), and 45 cases with mixed type (47.9%). Logistic regression analysis showed that older than 65 years, higher APACHE Ⅱ score, ICU admission due to trauma, drinking history, history of hypertension, metabolic acidosis, respiratory diseases, use of midazolam and mechanical ventilation were independent risk factors for delirium (P<0.05). Conclusion    The incidence of delirium in ICU is quite high. Patients older than 65 years, with high APACHEⅡ score, ICU admission for trauma, history of alcohol and hypertension, metabolic acidosis, and respiratory disease, may be prone to delirium after receiving midazolam and mechanical ventilation treatment.

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更新日期/Last Update: 2018-06-14