摘要
目的:分析重症患者镇静镇痛后发生谵妄的影响因素。方法:回顾性分析2018年1月至2023年11月该院收治的110例重症患者的临床资料,采用重症监护谵妄筛查量表(ICDSC)评估患者谵妄情况,根据是否发生谵妄将其分为谵妄组和未谵妄组。收集患者基线资料,采用Logistic回归分析重症患者镇静镇痛后发生谵妄的影响因素。结果:110例重症患者镇静镇痛后,52例发生谵妄,58例未发生谵妄,谵妄发生率为47.27%;两组性别、体质量指数、合并冠心病、合并高血压、合并糖尿病比较,差异均无统计学意义(P>0.05);谵妄组年龄>65岁、合并脑血管疾病、合并慢性阻塞性肺疾病、使用阿片类药物、镇静镇痛药物使用时间≥35 h、呼吸机使用时间≥49.5 h、住院时间≥5 d、无家属探视、C反应蛋白水平≥148.57 mg/L、序贯器官衰竭评估(SOFA)评分≥5.1分、急性生理与慢性健康评分系统Ⅱ(APACHEⅡ)评分≥13.06分、躁动-镇静量表(RASS)评分≥-3.79分占比均高于未谵妄组,差异有统计学意义(P<0.05);Logistic回归分析结果显示,年龄>65岁、合并脑血管疾病、住院时间≥5 d、无家属探视、APACHEⅡ评分≥13.06分、RASS评分≥-3.79分均为重症患者镇静镇痛后发生谵妄的危险因素(OR>1,P<0.05)。结论:年龄>65岁、合并脑血管疾病、住院时间≥5 d、无家属探视、APACHEⅡ评分≥13.06分、RASS评分≥-3.79分均为重症患者镇静镇痛后发生谵妄的危险因素。
Objective:To analyze influencing factors of delirium after sedation and analgesia in critically ill patients.Methods:The clinical data of 110 critically ill patients admitted to the hospital from January 2018 to November 2023 were retrospectively analyzed.The ICU delirium screening scale(ICDSC)was used to evaluate the delirium of these patients.According to the occurrence of delirium,they were divided into delirium group and non-delirium group.The baseline data of these patients were collected.The influencing factors of delirium after sedation and analgesia in the critically ill patients were analyzed.Results:Among the 110 critically ill patients,52 cases suffered from delirium,58 cases did not have delirium,the incidence of delirium was 47.27%.There were no significant differences in gender,body mass index,coronary heart disease,combined hypertension and combined diabetes mellitus between the two groups(P>0.05).The proportions of the patients with age>65 years old,combined cerebrovascular disease,combined chronic obstructive pulmonary disease,use of opioid drugs,duration of sedative and analgesic drugs≥35 h,duration of ventilator use≥49.5 h,hospitalization time≥5 d,no family visit,C-reactive protein≥148.57 mg/L,sequential organ failure assessment(SOFA)score≥5.1 points,acute physiology and chronic health scoring system II(APACHE II)score≥13.06 points,and Richmond agitation-sedation scale(RASS)score≥-3.79 points in the delirium group were higher than those in the non-delirium group,and the differences were statistically significant(P<0.05).Logistic regression analysis showed that age>65 years old,combined cerebrovascular disease,hospitalization time≥5 d,no family visit,APACHE II score≥13.06 points,RASS score≥-3.79 points were risk factors for delirium after sedation and analgesia in the critically ill patients(OR>1,P<0.05).Conclusions:Age>65 years old,combined cerebrovascular disease,hospitalization time≥5 days,no family visit,APACHE II score≥13.06,and RASS score≥-3.79 are the risk factors for delirium after sedation and analgesia in the critically ill patients.
作者
齐艳坡
闫圣杰
陈俊
廖煜
QI Yanpo;YAN Shengjie;CHEN Jun;LIAO Yu(Intensive Care Unit of Zhengzhou First People’s Hospital,Zhengzhou 450000 Henan,China)
出处
《中国民康医学》
2025年第24期1-4,共4页
Medical Journal of Chinese People’s Health
关键词
重症
镇静
镇痛
谵妄
影响因素
Critical illness
Sedation
Analgesia
Delirium
Influencing factor
