急诊监护室危重症患者发生谵妄的相关因素分析  

Analysis of related factors of delirium in critically ill patients in emergency care unit

作　　者：倪花[1] 周水鑫[1] 丁俊华[1] 吉云兰[1] NI Hua;ZHOU Shuixin;DING Junhua;JI Yunlan(Affi liated Hospital of Nantong University,Nantong,226001,China)

机构地区：[1]南通大学附属医院急诊医学科,江苏省南通市226001

出　　处：《护理实践与研究》2022年第14期2084-2087,共4页Nursing Practice and Research

基　　金：南通大学附属医院科技计划项目(编号:Tfh1909)。

摘　　要：目的分析急诊监护室危重症患者发生谵妄的影响因素,并制订相应处理对策。方法选取医院2019年5月—2021年5月急诊监护室收治的危重症患者354例为研究对象,对所有患者采用ICU意识模糊评估法进行谵妄评估,将其分为谵妄组(n=165)与非谵妄组(n=189),对比两组各项临床资料,并进行单因素分析,对单因素分析中的影响因素进行多因素Logistic回归分析,确定发生谵妄的影响因素,并制订相应处理对策。结果单因素分析显示,年龄、APACHEⅡ评分、严重水电解质紊乱、休克/低血压、呼吸衰竭、机械通气是急诊监护室危重症患者发生谵妄的相关影响因素(P<0.05)。多因素Logistic回归分析显示,年龄、APACHEⅡ评分、机械通气、呼吸衰竭是急诊监护室危重症患者发生谵妄的影响因素(P<0.05)。结论急诊监护室危重症患者谵妄发生的影响因素主要为年龄、APACHEⅡ评分、机械通气、呼吸衰竭,临床应尽早预防并采取相应处理措施,从而改善患者预后。Objective To analyze the infl uencing factors of delirium in critically ill patients in emergency care unit,and formulate corresponding countermeasures.Methods A total of 354 critically ill patients admitted to the hospital's emergency care unit from May 2019 to May 2021 were selected as the study objects.All patients were assessed for delirium using the ICU Confusion Assessment Method,and they were divided into a delirium group(n=165)and a non-delirium group(n=189).The clinical data of the two groups were compared,and univariate analysis was performed.Multivariate Logistic regression analysis was performed on the infl uencing factors in the univariate analysis to determine the infl uencing factors of delirium,and to formulate corresponding countermeasures.Results Univariate analysis showed that the age,APACHEⅡscores,severe water and electrolyte disturbances,shock/hypotension,respiratory failure,and mechanical ventilation were the related infl uencing factors of delirium in critically ill patients in the emergency care unit(P<0.05).Multivariate Logistic regression analysis showed that the age,APACHEⅡscores,mechanical ventilation,and respiratory failure were the infl uencing factors of delirium in critically ill patients in the emergency care unit(P<0.05).Conclusion The main infl uencing factors of delirium in critically ill patients in emergency care unit were age,APACHEⅡscores,mechanical ventilation and respiratory failure.Clinical prevention and corresponding measures should be taken as soon as possible to improve the prognosis of patients.

关 键 词：急诊监护室 危重症 谵妄 危险因素 处理对策 

分 类 号：R473.5[医药卫生—护理学]