心脏外科重症监护病房患者发生谵妄相关危险因素分析及对策  

Analysis and countermeasures of risk factors related to delirium in patients in ICU of cardiac surgery

作　　者：齐甜甜 王文[1] QI Tian-tian;WANG Wen

机构地区：[1]清华大学附属北京清华长庚医院,清华大学临床医学院,北京市102218

出　　处：《护理实践与研究》2020年第17期29-32,共4页Nursing Practice and Research

摘　　要：目的探讨心脏外科重症监护病房患者发生谵妄相关危险因素及防护对策。方法选取2018年3月至2019年12月入住本院心脏外科重症监护病房的心脏外科术后患者86例为研究对象,调查本组患者基本资料,总结谵妄发生情况,采用单因素和多因素logistic回归分析影响心脏外科重症监护病房患者发生谵妄的独立危险因素。结果本组86例患者中有28例发生谵妄,占32.56%。多因素logistic回归分析结果显示,高龄、家庭成员缺失、APACHEⅡ评分≥10分及机械通气时间>6 h是影响心脏外科重症监护病房发生谵妄的独立危险因素(P<0.05)。结论医护人员应针对心脏外科重症监护病房患者发生谵妄的高危因素做好预防工作,尤其是高龄患者的精神状态监测,改善ICU病房环境,及时发现并疏导患者负面情绪,尽量缩短机械通气时间,以预防谵妄的发生。Objective To explore the risk factors related to delirium in patients in ICU of cardiac surgery and its protective countermeasures.Methods To select 86 cases of patients who underwent cardiac surgery and were admitted to ICU of the cardiac surgery of our hospital from March 2018 to December 2019 as the study objects.The basic data of this group of patients were investigated and the incidence of delirium was summarized.Single-factor and multi-factor logistic regression were used to analyze the independent risk factors of delirium in patients in the cardiac surgery intensive care unit.Results 28 of the 86 patients in this group developed delirium,accounting for 32.56%.Multivariate logistic regression analysis showed that the old age,absence of family members,APACHEⅡscore≥10 points and the time of mechanical ventilation>6 hours were independent risk factors for delirium in ICU of the cardiac surgery(P<0.05).Conclusion Medical staff should take precautions against the high-risk factors of delirium in patients in ICU of the cardiac surgery,especially the mental status monitoring of elderly patients,improve the environment of the ICU ward,timely detect and ease the negative emotions of patients,and shorten the time of mechanical ventilation as much as possible to prevent the occurrence of delirium.

关 键 词：心脏外科 重症监护病房 谵妄 危险因素 

分 类 号：R473.6[医药卫生—护理学]