PCI术后谵妄危险因素分析及针对性预防护理对策  

Analysis of risk factors of early delirium after PCI and targeted preventive nursing strategies

作　　者：麻朴[1] 牛少琼 李春燕[1] 刘思蕾 杨丽[1] MA Pu;NIU Shaoqiong;LI Chunyan(The First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471000,China)

机构地区：[1]河南科技大学第一附属医院,洛阳471000

出　　处：《国际精神病学杂志》2021年第6期1138-1141,共4页Journal Of International Psychiatry

基　　金：河南省医学科技攻关计划(联合共建)项目(编号:LHGJ20190555)。

摘　　要：目的探讨急性冠脉综合征(ACS)患者经皮冠状动脉介入术(PCI)后出现谵妄的危险因素并讨论针对性预防护理对策。方法本研究观察对象为我院2020年1月~2021年1月132例ACS患者,均采用PCI术治疗,评估治疗期间谵妄发生情况,并设为谵妄组与非谵妄组。比较两组患者性别、年龄、合并症等一般资料,通过单因素与多因素分析调查PCI术后早期谵妄危险因素。结果132例ACS患者PCI术后早期发生谵妄36例,发生率27.27%;谵妄组与非谵妄组年龄、合并低氧血症、合并睡眠障碍、合并焦虑症、罪犯血管支数、使用苯二氮?类药、手术时间、术前心脏功能分级、心脏骤停史差异具有统计学意义(P<0.05),两组是否为急诊PCI术、性别、合并糖尿病、合并高血压、吸烟史差异无统计学意义(P>0.05);多因素Logistic回归分析显示,合并睡眠障碍、合并低氧血症、合并焦虑症、年龄>70岁、多支病变、使用苯二氮?类药是PCI术后早期谵妄危险因素。结论PCI术后早期谵妄发生率较高,危险因素包括睡眠障碍、低氧血症、焦虑症等,应据此开展针对性预防护理措施降低谵妄发生率。Objective To explore the risk factors of early delirium after percutaneous coronary intervention(PCI)in patients with acute coronary syndrome(ACS)and discuss targeted preventive and nursing strategies.Methods A total of 132 patients with ACS in our hospital from January 2020 to January 2021 were selected as the study subjects,and all of whom were treated with PCI.The occurrence of delirium during CCU treatment were evaluated,and they were set as the delirium group and the non-delirium group.The general data such as gender,age and comorbidities of the two groups of patients were compared.The risk factors of early delirium after PCI were investigated through univariate and multivariate analysis.Results 36 cases of delirium occurred early after PCI in 132 ACS patients,with an incidence rate of 27.27%.There are differences between the delirium group and the non-delirium group in age,combined with hypoxemia,combined with sleep disorders,combined with anxiety,criminal vessel count,use of benzodiazepines,operation time,preoperative cardiac function classification,and history of cardiac arrest Statistical significance(P<0.05).There was no statistically significant difference in whether the two groups were emergency PCI,gender,combined diabetes,combined hypertension,and smoking history(P>0.05).Multivariate logistic regression analysis showed that combined sleep disorders,hypoxemia,anxiety,age>70 years,multivessel disease,and use of benzodiazepines were risk factors for early delirium after PCI.Conclusion The incidence of early delirium after PCI is relatively high,and risk factors include sleep disorders,hypoxemia,anxiety,etc.Therefore,targeted preventive care measures should be implemented to reduce the incidence of delirium.

关 键 词：急性冠脉综合征 经皮冠状动脉介入术 谵妄 危险因素 预防护理对策 

分 类 号：R749.99[医药卫生—神经病学与精神病学]