ICU远程探视模式对患者认知功能的影响  

Effect of remote visitation mode on cognitive function of patients in ICU

作　　者：付晔 王华军[1] 周成杰 FU Ye;WANG Huajun;ZHOU Chengjie(Department of Intensive Care Unit,the Affiliated People’s Hospital of Ningbo University,Ningbo 315040,Zhejiang,China)

机构地区：[1]宁波大学附属人民医院重症医学科,浙江宁波315040

出　　处：《中国现代医生》2023年第28期29-32,共4页China Modern Doctor

基　　金：浙江省教育厅一般科研项目(Y202044132)。

摘　　要：目的分析重症监护病房(intensive care unit,ICU)采用远程探视对患者认知功能的影响。方法选取2021年7月至12月宁波大学附属人民医院ICU收治的147例患者为研究对象。根据探视模式的不同,将2021年7月至9月收治的73例患者纳入无探视组,将2021年10月至12月收治的74例患者纳入远程探视组。无探视组患者在ICU住院期间不能与家属进行任何形式的探视,而远程探视组患者与家属可通过微信视频进行预约定时探视。比较两组患者的谵妄发生率及右美托咪定使用量情况,采用多因素Logistic回归分析筛选影响ICU患者发生谵妄的危险因素。结果远程探视组患者的谵妄发生率显著低于无探视组(P<0.05),右美托咪定用量显著少于无探视组(P<0.05);多因素Logistic回归分析显示,年龄大、住院时间长、急性生理学和慢性健康状况评价Ⅱ评分高、内科疾病均是ICU患者发生谵妄的危险因素(P<0.05),进行远程探视是ICU患者发生谵妄的保护因素(P=0.007)。结论探视模式是患者发生谵妄的重要影响因素,ICU实施远程探视,可有效降低患者的谵妄发生率,减少ICU相关认知功能损害。Objective To analyze the effects of remote visitation on cognitive function of patients in intensive care unit(ICU).Methods A total of 147 patients admitted to the ICU of the Affiliated People’s Hospital of Ningbo University from July to December 2021 were selected as the study objects.According to the pattern of visits,73 patients admitted from July to September 2021 were included in non-visiting group,and 74 patients admitted from October to December 2021 were included in remote visiting group.Patients in non-visiting group were not allowed to have any form of visits with their families during their stay in ICU,while patients in remote visiting group and their families made appointments for regular visits through WeChat video.The incidence of delirium and the usage of dexmedetomidine were compared between the two groups.Multivariate Logistic regression analysis was used to screen the risk factors affecting delirium in ICU patients.Results The incidence of delirium in remote visiting group was significantly lower than that in non-visiting group(P<0.05),and the dosage of dexmedetomidine was significantly lower than that in non-visiting group(P<0.05).Multivariate Logistic regression analysis showed that age,long hospitalization,high scores of acute physiology and chronic health evaluationⅡ,and medical diseases were all risk factors for delirium in ICU patients(P<0.05),and remote visitation was a protective factor for delirium in ICU patients(P=0.007).Conclusion Visitation mode is an important factor affecting delirium in patients.Remote visitation in ICU can effectively reduce the incidence of delirium and cognitive impairment in ICU.

关 键 词：远程探视 谵妄 认知功能 

分 类 号：R749.92[医药卫生—神经病学与精神病学]