急诊重症患者谵妄发生的临床因素评估及预防性护理

Evaluation of clinical factors and preventive nursing of delirium in emergency critically ill patients

目的探讨急诊危重患者发生谵妄的临床相关因素和预防性护理对策。方法选取50例急诊危重谵妄患者(观察组)及50例非谵妄患者(对照组)为研究对象,对可能导致谵妄的临床因素进行分析。结果观察组在年龄、BMI、重症感染、脑血管疾病、肝脏疾病、糖尿病、APACHEⅡ评分、使用硝普钠、咪唑安定的比例以及机械通气方面与对照组比较,差异有统计学意义(P<0.05);多因素logistic回归分析发现,年龄、合并糖尿病、重症感染、APACHEⅡ评分、机械通气是急诊危重患者发生谵妄的独立危险因素(P<0.05)。结论急诊危重患者发生谵妄的诱发因素较多,应加强病情观察,采用预防性护理对策。

Objective To explore the clinical related factors of emergency critical ill patients and its preventive nursing countermeasures.Methods A total of 50 emergency critically ill patients with delirium in our hospital were as observation group and 50 non-delirium patients were as control group.The clinical factors that maylead to delirium of the patients were analyzed.Results Age,BMI,severe infection,cerebrovascular disease,liver disease,diabetes,APACHE score,the ratio of using sodium nitroprusside and midazolam,and mechanical ventilation in the observation group showed statistically significant differences compared to the control group(P<0.05).Multivariate logistic regression analysis showed that age,diabetes mellitus,severe infection,APACHEⅡscore and mechanical ventilation were independent risk factors for delirium in emergency critically ill patients(P<0.05).Conclusion There are many predisposing factors for delirium in emergency critical ill patients,so we should strengthen the observation of the patient's condition and adopt preventive nursing countermeasures.