PICU单纯疱疹病毒性脑炎患儿谵妄发生情况分析  

Analysis of the occurrence of delirium in children with herpes simplex virus encephalitis in PICU

作　　者：李勤云 

机构地区：[1]河南省南阳市第二人民医院,473000

出　　处：《首都食品与医药》2021年第11期35-37,共3页Capital Food Medicine

摘　　要：目的观察儿科重症监护病房(PICU)单纯疱疹病毒性脑炎(HSE)患儿谵妄发生情况,并探讨HSE患儿发生谵妄的影响因素,以指导未来该类疾病合理干预方案的拟定.方法选取2017年1月~2020年1月医院PICU收治的57例HSE患儿,观察并记录患儿治疗期间谵妄发生情况,依据是否发生谵妄分组.统计并比较发生组与未发生组的基线资料,并通过单因素与多因素分析检验HSE患儿发生谵妄的影响因素.结果全部57例HSE患儿,治疗期间发生谵妄14例,发生率为24.56%;发生组与未发生组年龄、性别、脑电图结果、头颅MRI结果、合并精神障碍、口唇疱疹史占比对比,差异无统计学意义(P>0.05);发生组巴比妥类药物史、合并感染、合并代谢异常、合并贫血、地西泮使用史占比均高于未发生组,差异有统计学意义(P<0.05);经单项Logistic回归分析后,建立多元回归模型行多因素分析,结果显示,巴比妥类药物史、合并感染、合并代谢异常、合并贫血、地西泮使用史均是HSE患儿发生谵妄的影响因素(OR>1,P<0.05).结论PICU内HSE患儿发生谵妄风险高,可能受巴比妥类药物史、合并感染、合并代谢异常等因素影响,临床应重视PICU内HSE患儿早期谵妄风险评估,针对有高危因素的患儿,应及时采取合理干预,可能对降低谵妄发生风险、改善患儿预后有积极意义.Objective To observe the occurrence of delirium in children with herpes simplex viral encephalitis(HSE)in the Pediatric Intensive Care Unit(PICU),and to explore the influencing factors of delirium in children with HSE,to guide the formulation of reasonable intervention plans for this type of disease in the future.Methods From January 2017 to January 2020,57 children with HSE treated in PICU of the hospital.Observed and recorded the occurrence of delirium during the treatment of children,and divided them into groups according to whether delirium occurred.Counted and compared the baseline data of the occurrence group and the non-occurrence group,and through univariate and multivariate analysis,tested the influencing factors of delirium in children with HSE.Results Among all 57 children with HSE,14 cases occurred delirium during treatment,the incidence was 24.56%;compared the proportion of age,gender,EEG results,head MRI results,combined mental disorders,and history of diazepam use between the occurrence group and the non-occurrence group,the difference was not statistically significant(P>0.05);the proportions of barbiturate history,combined infection,combined abnormal metabolism,combined anemia,and diazepam use history in the occurrence group were higher than those in the non-occurrence group,and the difference was statistically significant(P<0.05);after single logistic regression analysis,a multiple regression model was established and multi-factor analysis was performed.The results showed that history of barbiturates,combined infections,combined abnormal metabolism,combined anemia,and history of diazepam use were all influencing factors for the development of delirium in children with HSE(OR>1,P<0.05).Conclusion The risk of delirium in children with HSE in the PICU is high,which may be affected by the history of barbiturates,combined infections,and abnormal metabolism.The clinic should pay attention to the early risk assessment of delirium in children with HSE in PICU.For children with high-risk factors,timely an

关 键 词：单纯疱疹病毒性脑炎 儿科重症监护病房 谵妄 巴比妥类药物 感染 代谢异常 贫血 地西泮 

分 类 号：R512.3[医药卫生—内科学]