【摘要】 目的探讨重症监护室(ICU)危重症患者谵妄的主要原因,为减少ICU危重症患者谵妄的发生提供临床参考。方法选取ICU收治的431例危重症患者为研究对象,入院后根据病情进行治疗,观察是否发生谵妄,分析发生谵妄的相关原因。结果 431例患者发生谵妄者93例,谵妄发生率21.58%。患者年龄>60岁、初中及以下、使用硝普钠、使用咪唑安定、发热、低血压或心源性休克、电解质紊乱、有机械通气、感染、高血压、糖尿病时谵妄发生率明显增高,差异具有统计学意义(P<0.05);多因素Logistic回归分析显示文化程度低、发热、低血压或心源性休克、电解质紊乱、机械通气、感染、高血压、糖尿病是引起患者发生谵妄的独立危险因素(P<0.05)。结论 ICU危重症患者谵妄发生率高,患者文化程度低、发热、低血压或心源性休克、电解质紊乱、机械通气、感染、高血压、糖尿病是引起谵妄发生的主要原因,应针对以上因素积极进行治疗以减少谵妄发生。更多还原

【Abstract】 Objective To explore the main causes of delirium in critical patients in intensive care unit( ICU) in order to reduce the occurrence of delirium in critical patients of ICU and to provide clinical reference. Methods The clinical data of 431 critical patients in ICU were collected for this study according to the method of treatment for illness after admission,and the related causes for occurrence of delirium were also observed and analyzed. Results Among these 431 patients,delirium had been occurred in 93 cases,and the incidence of delirium was 21. 58%.Patients with age > 60 years old and education at junior high school level,usually administrated with sodium nitrate and imidazole,and accompanied with fever,low blood pressure or cardiogenic shock,electrolyte disorder,mechanical ventilation,infection,hypertension and / or diabetes were significantly higher in incidence of delirium,and the difference with other patients was statistically significant( P < 0. 05). Multivariate Logistic regression analysis showed that low degree of culture,fever,low blood pressure and cardiogenic shock,electrolyte disorder,mechanical ventilation,infection,hypertension and diabetes were independent risk factors responsible for occurrence of delirium in these patients( P < 0. 05).Conclusion The causes for high incidence of delirium in critically ill patients in ICU are low degree of culture,complicated with fever,low blood pressure,cardiogenic shock,electrolyte disorder,mechanical ventilation,infection,hypertension and / or diabetes are major causes for occurrence of delirium,hence patients with above risk factors in ICU should be actively treated in order to reduce the occurrence of delirium.更多还原