ICU患者谵妄危险因素分析

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目的

通过评分系统分析患者ICU谵妄发生的危险因素。

方法

对440例患者分别在入ICU即刻与出ICU时应用焦虑自评量表(SAS)、抑郁自评量表(SDS)及ICU谵妄筛查表(ICDSC)进行评价,同时记录发生ICU综合征的各种可能危险因素及入ICU及出ICU时的急性生理与慢性健康评分(APACHE Ⅱ)。分别对危险因素与出ICU时SAS、SDS及ICDSC评分的关系进行多元线性回归分析。

结果

患者转出ICU后,APACHE Ⅱ评分、SAS、SDS及ICDSC各项评分分别为(9.8±3.2),(43.8±11.3),(43.1±10.8)与(2.43±2.00)分,进入ICU时分别为(17.3±5.5),(48.3±12.7),(48.5±12.3),(1.36±0.81)分,差异有统计学意义(t值分别为7.549,3.004,3.780,-3.329;P<0.05)。逐步多元回归分析显示,SAS评分与住院天数、出院APACHE Ⅱ评分、引流管数量相关(R2=0.515,F=14.139,P<0.001);SDS评分与住院天数、引流管数量相关(R2=0.444,F=16.395,P<0.001);ICDSC评分与文化程度、住院天数、机械通气时间、出院APACHE Ⅱ评分相关(R2=0.803,F=39.769,P<0.001)。

结论

ICDSC诊断ICU谵妄的敏感性较高,可用于ICU谵妄的筛查。随着住ICU天数的增加,发生ICU谵妄的可能性增加。

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