心脏直视术后患者谵妄发生状况及影响因素的研究  

Incidence and Effect Factors in patients with delirium After Cardiac Surgery

作　　者：王琴英[1] 邢小英[1] 王媛[1] 汪玲果[1] 

机构地区：[1]陕西省人民医院心外监护室,陕西西安710068

出　　处：《国际护理医学》2019年第2期150-154,共5页INTERNATIONAL NURSING MEDICINE

摘　　要：目的:描述心脏术后患者谵妄发生状况,确定谵妄发生的影响因素。方法:采取便利抽样方法,抽取我院心脏外科ICU病房2016.01~2018.06进行住院治疗的心脏直视术后患者共754例。根据病人在ICU住院期间是否发生谵妄而分为病例组(158例)和对照组(596例),采用研究者自行设计调查表回顾性收集患者一般资料调查表和疾病相关资料调查表,对患者围术期各种因素进行单因素和多因素Logistic回归分析。结果:心脏直视手术后患者谵妄的发生率为20.95%。单因素分析结果显示:两组病人性别、年龄、手术名称、既往史、术前心功能、输血、术中体外循环时间、机械辅助通气时间、ICU滞留时间、IABP使用、术后动脉血氧分压、ICU期间行再次气管插管、术后24小时二次手术、术后肝肾功能损害、术后合并症、术后转归等因素比较差异有统计学意义(p>0.05);Logistic回归结果显示:性别、机械辅助通气时间、术后动脉血氧分压、ICU期间再次插管、术后肝肾功能、疾病转归、术后并发症是心脏直视术后发生谵妄的危险因素。结论:性别、机械辅助通气时间、术后动脉血氧分压、ICU期间再次插管、术后肝肾功能、疾病转归、术后并发症能增加心脏术后患者发生谵妄的风险,是术后谵妄发生的主要影响因素。Objective:To descriptive the incidence of delirium after cardiac surgery among patients in intensive care units.and to explore the effect factors of delirium after cardiac surgery,Method:A retrospective study was performed.754 patients who received a treatment in ICU after cardiac surgery in our hospital were selected by convenience sampling.The patients were divided into two groups according to the presence(158cases)or absence(596cases)of delirium after cardiac surgery.A Logistic regression analysis was made.Results:Delirium after cardiac surgery occurred in 20.95%of the 754 patients.Single factor analysis results showed that two group patients was statistically significant(p<0.05)compared with gender,age,surgery type,disease history,preoperative heart function,blood transfusion,intraoperative extracorporeal circulation time,mechanical ventilation time and ICU admission time,IABP use,postoperative arterial oxygen partial pressure and re-intubation during ICU admission,re-surgery on the fist 24 hours after cardiac surgery,postoperative liver and kidney function,postoperative complications,and prognosis of disease.Logistic regression showed that effect factors of delirium after cardiac surgery were gender,invasive mechanical ventilation duration,low arterial partial pressure of oxygen after cardiac surgery,retracheal intubation after cardiac surgery in the ICU,liver and kidney function after cardiac surgery,prognosis of disease,postoperative complication(arrhythmia、pulmonary infection、low cardiac output syndrome,etc).Conclusion:Gender,invasive mechanical ventilation duration,low arterial partial pressure of oxygen after cardiac surgery,re-tracheal intubation after cardiac surgery in the ICU,liver and kidney dysfunction after cardiac surgery,outcome of disease,postoperative complication(arrhythmia、pulmonary infection、low cardiac output syndrome,etc)are the effect factors of cardiac postoperative delirium.

关 键 词：心脏直视手术 谵妄 重症监护室 发生状况 

分 类 号：R47[医药卫生—护理学]