摘要
目的:分析ICU成人患者发生谵妄的危险因素,为临床早期识别谵妄的发生提供依据。方法:计算机检索数据库The Cochrane Library、Pub Med、Embase、Web of Science、CNKI、Wan Fang Data、VIP和CBM,搜集建库至2017年4月关于ICU患者发生谵妄危险因素的文献,利用Rev Man 5.3软件进行Meta分析。结果:共纳入26篇文献,累计病例组2 267例,对照组10 746例;各因素Meta分析合并比值比(OR)或加权均数差(WMD)分别为年龄>65岁(OR=2.19)、吸烟(OR=1.22)、慢性阻塞性肺疾病(COPD)(OR=2.08)、镇静药(OR=8.27)、机械通气(OR=3.46)、脓毒症(OR=8.88)、APACHEⅡ评分(WMD=3.77)、脑卒中(OR=2.20)、肾功能不全(OR=1.96)和身体约束(OR=9.99)。结论:基于现有证据,ICU患者谵妄危险因素有年龄>65岁、吸烟、COPD、使用镇静药、机械通气、脓毒症、高APACHEⅡ评分、脑卒中、肾功能不全和身体约束。
Objective： To explore the risk factors oflCU delirium in adult patients to provide the basis for early clinical identification of delirium. Methods： We searched databases including The Cochrane Library, PubMed, Embase, Web of Science, CNKI, WanFang Data, VIP and CBM from inception to April 2017, to collect the risk factors of ICU delirium in adult patients at home and abroad. RevMan 5.3 software were used for Meta-analysis. Results： Twenty-six studies were included, the cumulative cases were 2 267 delirium cases and 10 746 controls. The pooling effect sizes which include odds ratio （OR） values and weight mean difference （WMD） were age 〉65 years （OR=2.19）, smoking （OR=1.22）, COPD （OR=2.08）, sedatives （OR=8.27）, mechanical ventilation （OR=3.46）, sepsis （OR=8.88）, APACHE II score （WMD=3.77）, stroke （OR=2.20）, renal dysfunction （OR=1.96） and physical restraint （OR=9.99）, respectively. Conclusion： According to the present evidence, the risk factors of delirium in ICU patients are age 〉65 years, smoking, COPD, sedatives, mechanical ventilation, sepsis, APACHE Ⅱ score, stroke, renal dysfunction and ohvsical restraint.
作者
潘燕彬
江智霞
张晶晶
杨凯涵
权明桃
陈芳
曾慧
PAN Yanbin;JIANG Zhixia;ZHANG Jingling;YANG Kaihan;QUAN Mingtao;CHEN Fang;ZENG Hui(School of Nursing, Zunyi Medical University, Guizhou Province, 563003, Chin)
出处
《中国护理管理》
CSCD
北大核心
2018年第4期465-475,共11页
Chinese Nursing Management
基金
2016年度贵州省省级重点学科(黔学位合字ZDXK[2016]10号)
