危重症患者谵妄发生的危险因素调查及给予ABCDE集束化护理的作用研究  

Investigation on the Risk Factors of Delirium in Critically Ill Patients and the Effect of Abcde Cluster Nursing

作　　者：黄梅[1] HUANG Mei(The First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine,Nanning,Guangxi 530023)

机构地区：[1]广西中医药大学第一附属医院,广西南宁530023

出　　处：《智慧健康》2025年第3期176-179,共4页Smart Healthcare

摘　　要：目的调查危重症患者发生谵妄的危险因素,并分析实施ABCDE集束化护理的效果。方法以2022年8月—2024年3月收治的危重症患者96例为研究对象,依据是否发生谵妄分为谵妄组(发生谵妄,n=31)、非谵妄组(未发生谵妄,n=65),调查分析谵妄发生的独立危险因素,随之落实ABCDE集束化护理,比较谵妄组患者护理前后的急性生理学及慢性健康状况评分系统(APACHEⅡ)评分。结果谵妄组≥65岁率、既往病史率、有机械通气率及APACHEⅡ评分≥15分率均高于非谵妄组(P<0.05);≥65岁、既往病史、有机械通气、APACHEⅡ评分≥15分是危重症患者发生谵妄的独立危险因素,差异有统计学意义(P<0.05);谵妄组护理后APACHEⅡ评分低于护理前(P<0.05)。结论通过调查,导致危重症患者发生谵妄的因素多样,而积极开展有效的护理干预,有效改善其预后,值得借鉴。Objective To investigate the risk factors of delirium in critically ill patients and analyze the effect of ABCDE cluster nursing.Methods A total of 96 critically ill patients admitted from August 2022 to March 2024 were selected as the study objects.According to whether delirium occurs,they were divided into delirium group(delirium occurs,n=31)and non-delirium group(delirium does not occur,n=65).Independent risk factors for delirium were investigated and analyzed,and then ABCDE cluster nursing was implemented.The acute physiology and Chronic Health status Scoring System(APACHEII)scores were compared before and after care in delirium group.Results The rates of≥65 years old,past medical history,mechanical ventilation and APACHEⅡscore≥15 points in delirium group were higher than those in non-delirium group(P<0.05).≥65 years old,past history,mechanical ventilation,APACHEⅡscore≥15 points were independent risk factors for delirium in critically ill patients,and the difference was statistically significant(P<0.05).The score of APACHEⅡin delirium group after nursing was lower than that before nursing(P<0.05).Conclusion Through investigation,there are various factors leading to delirium in critically ill patients,and active and effective nursing intervention can effectively improve the prognosis,which is worthy of reference.

关 键 词：危重症 谵妄 危险因素 ABCDE集束化护理 护理效果 

分 类 号：R473[医药卫生—护理学]