危重症患者发生重症监护病房谵妄的危险因素分析  

Risk Factors for ICU Delirium in Critical Patients

作　　者：宁艳花[1] 张琳[1] 王儒林[2] 马玉杰[2] 

机构地区：[1]宁夏医科大学护理学院,宁夏银川市750004 [2]宁夏医科大学总医院

出　　处：《中国全科医学》2013年第20期2358-2361,共4页Chinese General Practice

基　　金：2011年宁夏高等学校科学技术研究项目(宁教高[2011]263号)

摘　　要：目的探讨危重症患者发生重症监护病房(ICU)谵妄的危险因素。方法选取2011年3—9月入住宁夏医科大学附属医院ICU的非心脏手术患者319例,根据诊断结果将患者分为ICU谵妄组100例和非ICU谵妄组219例。收集患者的临床资料、血常规结果、血生化结果等,计算急性生理功能和慢性健康状况评分系统Ⅱ(APACHEⅡ)评分。危险因素的分析采用多因素Logistic回归分析。结果单因素分析结果显示,两组患者的文化程度、职业、民族、医疗费报销比例、发热发生率、APACHEⅡ评分、糖尿病发生率、高血压发生率、白细胞计数、中性粒细胞绝对值、中性粒细胞相对值、红细胞计数、血红蛋白、钙、尿素、总蛋白、球蛋白、天门冬氨酸氨基转移酶/丙氨酸氨基转移酶、胆碱酯酶比较,差异均有统计学意义(P<0.05)。多元Logistic回归分析结果显示,民族、文化程度、合并糖尿病、合并高血压、发热、APACHEⅡ评分、钙、胆碱酯酶、白细胞计数进入回归方程(P<0.05)。结论民族、文化程度、合并糖尿病、合并高血压、APACHEⅡ评分、钙、胆碱酯酶、发热、白细胞计数是危重症患者发生ICU谵妄的危险因素。Objective To investigate the risk factors of ICU delirium in critical patients.Methods A total of 319 ICU non-cardiac surgery patients admitted to the Affiliated Hospital of Ningxia Medical University from March to September of 2011 were divided,according to diagnosis results,into groups delirium（n = 100）,non-delirium（n = 219）.Clinical data,results of blood routine examination and biochemistry were analyzed,scores of acute physiology and chronic health evaluation Ⅱ（APACHE Ⅱ） were calculated.Multivariate Logistic regression analysis was used to analyze risk factors.Results By univariate analysis,there was significant difference between 2 groups in educational level,occupation,ethnicity,reimbursement proportion of medical expenses,APACHE Ⅱ scores,incidences of fever,diabetes and hypertension,leukocyte count,absolute neutrophil count,relative value of neutrophils,erythrocyte count,hemoglobin,calcium,Ur,total protein,globulin,aspartate aminotransferase / alanine aminotransferase,cholinesterase（P〈 0.05）.By multivariate Logistic regression analysis,there was difference in effects of ethnicity,educational level,combination with diabetes or hypertension,fever,APACHE Ⅱ scores,calcium,cholinesterase,leukocyte count on regression equation（P〈 0.05）.Conclusion Ethnicity,educational level,combinations of diabetes or hypertension,APACHE Ⅱ score,calcium,cholinesterase,fever,leukocyte are risk factors of ICU delirium in critical patients.

关 键 词：重症监护病房 谵妄 危险因素 

分 类 号：R197.38[医药卫生—卫生事业管理] R749.2[医药卫生—公共卫生与预防医学]