ICU患者谵妄持续时间及其影响因素的研究

发布时间：2018-11-27 07:04

【摘要】：目的描述ICU患者谵妄持续时间的现状并分析其影响因素。方法选取北京协和医院重症医学科2016年4月—2017年1月发生ICU谵妄的77例患者作为研究对象。于患者首次发生谵妄后,收集患者一般资料以及机械通气、镇静镇痛药物使用、抗精神病药物使用时间、缺氧时间、感染、内环境、谵妄类型等临床资料,记录对患者所采取的谵妄管理措施,至患者谵妄评估为阴性或转出ICU。通过Kaplan-Meier单因素分析和Cox多因素分析探讨ICU谵妄持续时间的影响因素。结果 ICU谵妄持续时间为(5.06±4.59)d;急性生理和慢性健康评分(χ~2=4.670,P=0.031)、是否为持续性谵妄(χ~2=5.801,P=0.016)、缺氧时间(χ~2=14.438,P0.001)及抗精神病药物使用时间(χ~2=13.360,P0.001)为ICU谵妄持续时间的影响因素。结论 ICU患者谵妄持续时间变异度较大,医护人员应对病情严重程度高、持续性谵妄、存在缺氧的患者加强谵妄管理,并慎用抗精神病药物,以尽可能降低谵妄持续时间,改善患者预后。
[Abstract]:Objective to describe the status of delirium duration in ICU patients and analyze its influencing factors. Methods 77 patients with delirium ICU from April 2016 to January 2017 in Peking Union Hospital were selected as study subjects. After the first occurrence of delirium, the general information of the patient and the clinical data such as mechanical ventilation, sedation and analgesic drug use, antipsychotic use time, anoxic time, infection, internal environment, delirium type and so on were collected. Record the management of delirium in the patient until the patient's delirium is assessed as negative or out of ICU. The factors influencing the duration of ICU delirium were investigated by Kaplan-Meier single factor analysis and Cox multivariate analysis. Results the duration of delirium in ICU was (5.06 卤4.59) days. The scores of acute physiology and chronic health (蠂 ~ 2 = 4.670) were continuous delirium (蠂 ~ 2 = 5.801), anoxia time (蠂 ~ 2 = 14.438p 0.001) and antipsychotic drug use time (蠂 ~ 2 = 13.360). P0. 001) is a factor influencing the duration of ICU delirium. Conclusion the degree of variation of delirium duration in patients with ICU is greater, the medical staff has a high degree of coping, persistent delirium, and the patients with anoxia strengthen the management of delirium, and use antipsychotics carefully to reduce the duration of delirium as far as possible. To improve the prognosis of patients.
【作者单位】：北京市北京协和医学院护理学院;中国医学科学院北京协和医院重症医学科;
【分类号】：R473

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