ICU呼吸衰竭机械通气患者谵妄影响因素分析  

Analysis of Influence Factors of Delirium in ICU Patients with Respiratory Failure and Mechanical Ventilation

作　　者：夏娟娟[1] 韩海霞[2] 李月霞[2] 刘立云[2] 刘莉[2] Xia Juanjuan;Han Haixia;Li Yuexia(Binzhou Medical College,Binzhou Shandong 256600,China)

机构地区：[1]滨州医学院,山东滨州256600 [2]滨州医学院附属医院

出　　处：《齐鲁护理杂志》2019年第3期40-43,共4页Journal of Qilu Nursing

摘　　要：目的:探讨ICU呼吸衰竭机械通气患者发生谵妄的影响因素。方法:选取滨州市某三甲医院收入ICU呼吸衰竭机械通气患者为研究对象,收集患者年龄、性别、文化程度、是否首次入住ICU、ICU环境压力源评分、急性生理学及慢性健康状况评分、PaO_2、机械通气时间、睡眠障碍、约束、疼痛等资料,采用多元Logistic回归模型分析ICU呼吸衰竭机械通气患者发生谵妄的危险因素。结果:共纳入60例呼吸衰竭机械通气患者,其中发生谵妄34例,发生率为56. 7%。单因素分析结果显示,ICU环境压力源评分、PaO_2、急性生理学及慢性健康状况评分、机械通气时间、文化程度、约束、疼痛对ICU呼吸衰竭机械通气患者并发谵妄的影响具有统计学意义(P <0. 05);多元Logistic回归模型结果显示,疼痛、急性生理学及慢性健康状况评分、ICU环境压力源评分是ICU呼吸衰竭机械通气患者谵妄发生的独立危险因素。结论:ICU呼吸衰竭机械通气患者谵妄发生率处于较高水平,疼痛> 4分、急性生理学及慢性健康状况评分≥15分、高ICU环境压力易诱发谵妄。Objective:To explore the influence factors of delirium in ICU patients with respiratory failure and mechanical ventilation.Methods:Patients with respiratory failure and mechanical ventilation in ICU admitted to a third-class A hospital in Binzhou city were selected as the research objects.Patients′age,gender,education level,whether they were admitted to ICU for the first time,ICU environmental stressor score,acute physiology and chronic health status score,PaO2,mechanical ventilation time,sleep disorders,constraints,pain and other data were collected.Multivariate Logistic regression model was used to analyze the risk factors of delirium in ICU patients with respiratory failure and mechanical ventilation.Results:This study included 60 patients with 34 cases of delirium,and the incidence of delirium was 56.7%.The result of single factor analysis showed that ICU environmental stressor score,PaO2,acute physiology and chronic health status score,mechanical ventilation time,education level,restraint,and pain had statistically significant effects on delirium of ICU patients with mechanical ventilation in respiratory failure(P<0.05).The results of multiple Logistic regression model showed that pain,acute physiology and chronic health status score,and ICU environmental stressor score were independent risk factors for delirium in ICU patients with respiratory failure and mechanical ventilation.Conclusion:The incidence of delirium in ICU patients with respiratory failure and mechanical ventilation is still high.Pain score is more than 4 points,acute physiology and chronic health status score is more than 15 points,so high ICU environment pressure is easy to induce delirium.

关 键 词：ICU 呼吸衰竭 机械通气 谵妄 

分 类 号：R473.5[医药卫生—护理学]