A型主动脉夹层术患者术后谵妄的影响因素分析

Analysis of influencing factors of postoperative delirium in patients with type A aortic dissection

目的探讨A型主动脉夹层术患者术后谵妄影响因素及护理对策。方法选取2017年1月至2018年1月我院收治的A型主动脉夹层术患者82例为研究对象,通过问卷调查方式收集患者一般资料。记录术后谵妄发生情况,采用多因素logistic回归分析法分析A型主动脉夹层术患者术后谵妄的相关影响因素。结果82例患者中术后发生谵妄18例,占21.95%,其中发生短暂性谵妄11例,发生持续性谵妄7例。单因素分析显示,年龄、糖尿病史、脑梗死史、动脉夹层病史、冠心病、手术持续时间、术中最低动脉压、ICU持续时间、术后最低氧合指数及机械通气时间为A型主动脉夹层术患者术后谵妄的相关影响因素(P<0.05);多因素logistic回归分析结果显示,年龄、脑梗死史、ICU持续时间、术后最低氧合指数及机械通气时间均为A型主动脉夹层术患者术后谵妄的独立危险因素。结论通过对A型主动脉夹层术患者术后谵妄的相关影响因素进行早期识别和分析,临床可采取相应的护理措施,提升患者预后及康复进程,能降低术后谵妄的发生概率。

Objective To explore the influencing factors of postoperative delirium in patients with type A aortic dissection and nursing countermeasures.Methods To select 82 cases of patients with type A aortic dissection who were admitted to our hospital from January 2017 to January 2018 as the study subjects,and the general information of the patients was collected through a questionnaire survey.The incidence of postoperative delirium was recorded,and the related factors of postoperative delirium in patients with type A aortic dissection were analyzed by multivariate logistic regression analysis.Results In the 82 cases of patients,18 cases had postoperative delirium,accounting for 21.95%,of which 11 cases had transient delirium and 7 cases had persistent delirium.Univariate analysis showed that the age,history of diabetes,history of cerebral infarction,history of arterial dissection,coronary heart disease,duration of surgery,minimum intraoperative arterial pressure,ICU duration,minimum postoperative oxygenation index and mechanical ventilation time were the related factors of postoperative delirium in patients with type A aortic dissection(P<0.05).Multivariate logistic regression analysis showed that the age,history of cerebral infarction,ICU duration,minimum postoperative oxygenation index and mechanical ventilation time were the independent risk factors of postoperative delirium in patients with type A aortic dissection.Conclusion Early identification and analysis of related influential factors of postoperative delirium in patients with type A aortic dissection should be performed,clinical nursing measures should be taken to improve the prognosis and rehabilitation process of patients,and reduce the incidence of postoperative delirium.