心脏外科术后谵妄的临床特点和危险因素分析  

Analysis of clinical characteristics and risk factors of postoperative delirium after cardiac surgery

作　　者：易进[1] 崔飞环 梁玉兰[1] 张娜[1] 王雪梅 YI Jin;CUI Feihuan;LIANG Yulan;ZHANG Na;WANG Xuemei(Department of Psychology,Beijing Anzhen Hospital,Capital Medical University,Beijing Institute of Heart,Lung and Blood Vessel Diseases,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所精神心理科,100029

出　　处：《心肺血管病杂志》2024年第5期469-473,共5页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:探讨心脏外科术后谵妄发生情况和危险因素。方法:回顾性分析2020年3月至2020年9月,北京安贞医院心外科某病房,收治的172例心脏外科开胸手术患者,其中男105例,女67例;年龄20~82岁,平均(58.5±11.6)岁。经过精神科医生会诊,并采用谵妄量表(the confusion assessment method,CAM)量表进行谵妄评估,将患者分为谵妄组(83例)和对照组(89例),分析患者术后谵妄的临床特点及相关危险因素。结果:心脏外科手术的患者术后谵妄发生率48.3%(83/172),临床表现依次为定向力障碍、睡眠-觉醒周期紊乱和注意障碍。Logistic多因素回归分析显示高龄、既往脑血管病史、ICU停留时间及术后低血压是术后谵妄的危险因素。结论:心脏外科术后谵妄率高,阴性症状更多。高龄、既往脑血管病史、ICU停留时间长、术后低血压是心脏外科手术后发生谵妄的危险因素。Objective:To explore the occurrence and risk factors associated with postoperative delirium in patients undergoing cardiac surgery.Methods:A retrospective analysis was conducted on 172 patients who underwent open-heart surgery and were admitted to the cardiac surgery ward at Anzhen Hospital in Beijing between March 2020 and September 2020.The group consisted of 105 males and 67 females,with ages ranging from 20 to 82 years old and an average age of(58.5±11.6)years old.Following consultation with a psychiatrist and assessment of delirium using the CAM scale,the patients were divided into a delirium group(83 cases)and a control group(89 cases)for analysis of the clinical characteristics of postoperative delirium and related risk factors.Results:In this study,48.3%(83/172)of patients undergoing cardiac surgery experienced postoperative delirium.The clinical manifestations of delirium were disorientation disorder,sleepwake cycle disorder,and attention disorder in that order.Logistic multifactorial regression analysis identified advanced age,previous history of cerebrovascular disease,ICU stay,and postoperative hypotension as risk factors for postoperative delirium.Conclusions:Postoperative delirium following cardiac surgery is prevalent and associated with negative symptoms.Risk factors for delirium after cardiac surgery include advanced age,a history of cerebrovascular disease,prolonged ICU stay,and postoperative hypotension.

关 键 词：心脏外科手术 术后谵妄 危险因素 

分 类 号：R54[医药卫生—心血管疾病]