ICU谵妄患者不同临床分型与短期预后的关系  

Relationship between different clinical types and short-term prognosis in ICU Delirium patients

作　　者：吴智鑫[1] 吴清玉 吴曦 黄少娟[1] 魏思源 范文定 苏懿[1] 雷俊娜[1] WUZhi-xin;WU Qing-yu;WU Xi;HUANG Shao-juan;WEI Si-yuan;FAN Wen-ding;SU Yi;LEI Jun-na(Neurological Intensive Care Unit,Foshan Hospital of Traditional Chinese Medicine(the Eighth Clinical Medical College of Guangzhou University of Chinese Medicine),Foshan 528000,Guangdong,China)

机构地区：[1]佛山市中医院(广州中医药大学第八临床医学院)神经重症监护病房,广东佛山528000

出　　处：《广东医学》2024年第8期1071-1076,共6页Guangdong Medical Journal

基　　金：国家自然科学基金项目(82374216);广东省科学技术厅基础与应用基础研究基金项目(粤佛地区培育项目)(2022A1515140060);广东省中医药局科研项目(20241307);佛山市科学技术局自筹经费类科技创新项目入库(2220001005576,2220001005080);广东省医学科研基金项目(A2023198);佛山市医学科研课题(20240097)。

摘　　要：目的探索谵妄患者的临床分型分布及其短期预后的关系。方法纳入重症监护病房(ICU)、急诊重症监护病房(EICU)、神经重症监护病房(NICU)、神经外科重症病房收治的谵妄患者共152例。根据标准对患者进行临床分型,收集患者的机械通气、谵妄、ICU住院时间、总住院时间等指标,采用描述性统计谵妄患者的临床分型分布,并探讨其与短期预后的关系。结果152例病例中男84例(55.3%),女68例(44.7%),平均(62.42±11.29)岁。临床分型分布上,活动亢进型(42.8%)>混合型(40.8%)>活动抑制型(16.4%)。活动亢进组、混合组、活动抑制组的病死率分别为16.9%、37.1%、40.0%,活动亢进组的死亡率最低,且与其他两个分型之间差异有统计学意义(P<0.05),其余两个分型间病死率差异无统计学意义(P>0.05)。活动亢进组、混合组、活动抑制组总住院时间分别是24.0(3.0,55.5)、39.00(18.75,63.25)、27.00(13.00,48.50)d,活动亢进组的总住院时间比活动抑制组短,差异有统计学意义(P<0.05),其余分型间总住院时间差异无统计学意义(P>0.05);活动亢进组、混合组、活动抑制组ICU住院时间分别为7.00(3.00,15.5)、11.00(3.00,20.00)、16.00(8.50,28.00)d,活动亢进组的ICU住院时间比活动抑制组低,差异有统计学意义(P<0.05),其余分型间ICU住院时间差异无统计学意义(P>0.05);活动亢进组、混合组、活动抑制组谵妄时间分别为3.00(1.00,6.00)、2.50(1.00,4.25)、6.00(4.00,9.00)d,活动抑制组的谵妄时间最长,且与其他两个分型之间差异有统计学意义(P<0.05),其他两个分型间谵妄时间差异无统计学意义(P>0.05)。结论临床分型中活动亢进型谵妄患者最多,活动抑制组和混合组谵妄患者短期预后比活动亢进组差。Objective To explore the distribution of clinical subtypes of delirium patients and their relationship with short-term prognosis.Methods A total of 152 delirium patients admitted to the Intensive Care Unit(ICU),Emergency Intensive Care Unit(EICU),Neurological Intensive Care Unit(NICU),and Neurosurgery Intensive Care Unit were included.Patients were clinically classified according to standards,and indicators such as mechanical ventilation,delirium duration,ICU stay,and total hospital stay were collected.Descriptive statistics were used to analyze the distribution of clinical subtypes and their relationship with short-term prognosis.Results Among the 152 cases,84 were male(55.3%)and 68 were female(44.7%),with an average age of(62.42±11.29)years.The distribution of clinical subtypes was hyperactive(42.8%)>mixed(40.8%)>hypoactive(16.4%).The mortality rates for the hyperactive,mixed,and hypoactive groups were 16.9%,37.1%,and 40.0%,respectively,with the hyperactive group having the lowest mortality rate and significant differences compared to the other two subtypes(P<0.05).There were no significant differences in mortality rates between the mixed and hypoactive groups(P>0.05).The total hospital stay for the hyperactive,mixed,and hypoactive groups was 24.0(3.0,55.5),39.00(18.75,63.25),and 27.00(13.00,48.50)days,respectively.The hyperactive group had a shorter total hospital stay than the hypoactive group,with significant differences(P<0.05).There were no significant differences in total hospital stay between the other subtypes(P>0.05).ICU stay for the hyperactive,mixed,and hypoactive groups was 7.00(3.00,15.5),11.00(3.00,20.00),and 16.00(8.50,28.00)days,respectively.The hyperactive group had a shorter ICU stay compared to the hypoactive group,with significant differences(P<0.05).There were no significant differences in ICU stay between the other subtypes(P>0.05).Delirium duration for the hyperactive,mixed,and hypoactive groups was 3.00(1.00,6.00),2.50(1.00,4.25),and 6.00(4.00,9.00)days,respectively.The hypoactive group

关 键 词：谵妄 临床分型 短期预后 

分 类 号：R749.1[医药卫生—神经病学与精神病学] R442.9[医药卫生—临床医学]