神经外科ICU患者谵妄特点分析  

Analysis on characteristics of delirium among neurosurgery intensive care unit patients

作　　者：纪媛媛 王军[1] 马春梅[1] Ji Yuanyuan;Wang Jun;Ma Chunmei(Department of Neurosurgery,Xuanwu Hospital Capital Medical University,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院神经外科,北京100053

出　　处：《中华现代护理杂志》2018年第25期2982-2986,共5页Chinese Journal of Modern Nursing

基　　金：首都护理学研究专项重点课题（16HL05）

摘　　要：目的 了解神经外科ICU患者谵妄的发生率，对患者发生谵妄的特点进行分析。方法 采用前瞻性队列研究设计，应用连续入组方便抽样方法，对2016 年5 月—2017 年7 月某三级甲等医院神经外科ICU收治的150 例患者为调查对象，使用意识错乱评估方法量表（CAM-ICU）每天进行谵妄评估，运用Logistic 回归分析谵妄的相关危险因素。结果 本组患者谵妄发生率为42%。谵妄发生类型以活动增多型为主，占36.5%；57.1% 的患者在入ICU 后2～5 d 发生谵妄。Logistic 回归分析显示，急性生理与慢性健康评分Ⅱ（APACHE Ⅱ）（OR=0.901， 95% CI 0.813～0.998）、身体约束（OR=11.382，95% CI 3.616～35.826）、低蛋白血症（OR=6.102，95% CI 1.729～21.530）是神经外科ICU 患者谵妄的独立预测因子。结论 神经外科ICU 患者谵妄的发生率高，诱发患者谵妄的危险因素较多，应密切注意患者精神状态的改变，以便早期采取有效措施预防谵妄的发生。Objective To explore the incidence of delirium among Neurosurgery Intensive Care Unit （ICU） patients and analyze the characteristics of delirium. Methods This study carried out perspective cohort study design. From May 2016 to July 2017, we selected 150 Neurosurgery ICU patients of a Class Ⅲ Grade A hospital by convenience sampling as respondents. Delirium was evaluated with the Confusion Assessment Method for the ICU （CAM-ICU） daily. Logistic regression was used in data analysis to analyze the related risk factors of delirium. Results The incidence of delirium of was 42% in those patients. Types of delirium were main in the type of increasing activity accounting for 36.5%. There were 57.1% of patients with delirium two to five days after being admitted to ICU. Logistic regression analysis showed that the independent predictors of delirium of Neurosurgery ICU patients were Acute Physiology, Age, Chronic Health Evaluation Ⅱ （APACHE Ⅱ） （OR=0.901, 95% CI 0.813-0.998）, physical restraint （OR=11.382, 95% CI 3.616-35.826）, hypoproteinemia （OR=6.102, 95% CI 1.729-21.530）. Conclusions The incidence of delirium is high in Neurosurgery ICU patients. There are many risk factors inducing delirium of patients. We should closely pay attention to patients ＇ mental state so as to early take effective measures to prevent delirium.

关 键 词：谵妄 重症监护 危险因素 神经外科 

分 类 号：R473.6[医药卫生—护理学]