主动脉夹层术后谵妄的临床特点和相关危险因素研究

Clinical characteristics and risk factors of postoperative delirium in patients with aortic dissection

目的研究主动脉夹层术后谵妄的发生率和相关危险因素。方法对84例主动脉夹层术后患者采用意识错乱评估方法进行谵妄诊断,并结合临床资料分析术后谵妄的危险因素。结果主动脉夹层术后谵妄的发生率为33.3%。21例(75%)为一过性谵妄(<24h);7例(25%)为持续性谵妄。Logsistic多因素回归分析结果表明脑梗死、深低温停循环时间、重症监护病房持续时间是术后谵妄的危险因素。结论既往脑梗死、深低温停循环时间、重症监护病房持续时间是主动脉夹层患者术后谵妄的独立危险因素。

Objective To study the incidence rate and risk factors of postoperative delirium in patients with aortic dissection. Methods 84 patients after aortic dissection surgery were evaluated with Confusion Assessment Method （CAM） to make the diagnosis of postoperative delirium. Patients＇ clinical informations were analyzed to detect the risk factors of postoperative delirium. Results The incidence rate of postoperative delirium was 33.3% in patients after aortic dissection surgery, in which 21 cases （75%） were transient delirium and 7 cases （25%） were persistent delirium. Logistic multifaetor stepwise regression analysis indicated that the risk factors of postoperative delirium included history of brain infarction, deep hypothermie circulatory arrest （DHCA） time and ICU stay time. Conclusion Previous brain infarction, DHCA time and ICU stay time are independent risk factors of postoperative delirium in patients with aortic dissection.