冠状动脉旁路移植术后谵妄的临床研究  

A clinical study on postoperative delirium in the patients undergoing coronary artery bypass grafting

作　　者：李晓晴[1] 马闻建[1] 姜霁纹[1] 王超[1] 王力[1] 刘水平[1] LI Xiaoqing MA Wenjian JIANG Jiwen WANG Chao WANG Li LIU Shuiping(Department of Neurology, Bering Anzhen Hospital, Capital Medical University, Beifing Institute of Heart, Lung and Blood Vessel Diseases, Beijing 100029, China)

机构地区：[1]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所神经内科,100029

出　　处：《心肺血管病杂志》2017年第8期662-664,共3页Journal of Cardiovascular and Pulmonary Diseases

基　　金：首都医学发展科研基金(2009-2075)

摘　　要：目的:研究冠状动脉旁路移植术(CABG)后谵妄的发生率和相关危险因素。方法:以CABG术住院患者为研究对象,以《谵妄评估方法》作为谵妄诊断工具,分析术后谵妄的发生率、临床特点和危险因素。结果:(1)术后谵妄发生率为11.0%(99/896例);(2)常见的临床表现包括精神运动性兴奋、注意障碍和意识水平改变;(3)单因素分析显示年龄≥70岁、脑梗死、脑出血、脑白质疏松、手术持续时间、ICU病房时间与术后谵妄发生相关;(4)Logsistic多因素回归分析显示年龄、脑梗死、ICU病房时间是术后谵妄的独立危险因素。结论:CABG术后谵妄与多种因素有关,对于既往有脑梗死的老龄患者,术前评估及提前处理,可能减少谵妄发生。Objective： To study the morbidity and risk factors of postoperative delirium in the patients undergoing coronary artery bypass grafting（ CABG）. Methods： The patients after coronary artery bypass grafting were evaluated with Confusion Assessment Method（ CAM）. Morbidity and risk factors of postoperative delirium were analyzed. Results：（1）Delirium occurred in 99 patients of 896 patients and morbidity of postoperative delirium was 11. 0%.（2） The common clinical presentations include increased psychomotor activity,attention impairment and a reduced level of consciousness.（3）Univariate logistic regression analysisresult showed that delirium was associated with advanced age（ ≥ 70years）,previous cerebral infarction,previous brain heamorrhage,white matter leukoaraiosis,surgery time,intensive care unit duration time.（4）The multiple logistic stepwise regression analysis indicated that the perioperative risk factors of delirium included advanced age,cerebrovascular accident history and ICU duration time. Conclusion： Many predisposing and precipitating factors contributed to postoperative delirium. Preventive strategies should be considered among those old patients with previous cerebral infarction.

关 键 词：冠状动脉旁路移植术 术后谵妄 发生率 危险因素 

分 类 号：R54[医药卫生—心血管疾病]