ICU病人亚谵妄综合征发生现状调查及原因分析

The status quo survey and causative analysis of ICU patients with subdelirium syndrome

[目的]调查分析重症监护室(ICU)病人亚谵妄综合征发生现状及原因。[方法]选取某三级甲等医院入住ICU的病人为研究对象,使用ICU病人意识模糊评估法(Confusion Assessment Method for the Intensive Care Unit,CAM-ICU)进行亚谵妄评估,收集病人临床资料。使用综合性医院ICU护士亚谵妄综合征知信行现况调查问卷对405名ICU护士进行认知现况调查。[结果]共纳入200例病人,ICU病人发生亚谵妄综合征66例,发生率为32.7%,其中15例病人由亚谵妄状态进展为谵妄,亚谵妄综合征病人中69.70%病人以意识状态急性改变或波动为特征改变,且急性生理和慢性健康(APACHEⅡ)评分、使用镇静镇痛药物和使用机械通气是ICU病人亚谵妄综合征发生的独立影响因素。此外,护士对亚谵妄综合征的知识、态度、行为3个维度满分比分别为48.64%、81.14%、70.46%。[结论]ICU病人亚谵妄综合征发生率较高,病人易由亚谵妄进展为谵妄状态,且临床上护理人员对亚谵妄认知不足,护士应加强对亚谵妄认知与评估,及时干预,预防谵妄的发生。

Objective:To investigate and analyze the status quo and causes of subdelirium syndrome in ICU patients.Methods:The patients who were admitted to ICU in a third grade A hospital were selected as the research objects,and the Confusion Assessment Method for the Intensive Care Unit(CAM-ICU)was used for the assessment of subdelirium syndrome and the clinical data of the patients were collected.The ICU nurses′Knowledge-Attitude-Practice(KAP)questionnaire of subdelirium syndrome was used to conduct a survey among 405 ICU nurses in general hospitals.Results:A total of 200 patients were included in this study,of subdelirium syndrome occurred in 66 cases,and the incidence was 32.7%.Among them,15 patients progressed from sub delirium to delirium.69.70%of patients with subdelirium syndrome had acute consciousness changes or fluctuations as characteristics;the APACHEII score,the usage of sedative and analgesic drugs,and the usage of mechanical ventilation were independent influencing factors for the occurrence of subdelirium syndrome in ICU patients.In addition,the nurses′KAP of subdelirium syndrome were 48.64%,81.14%,and 70.46%,respectively.Conclusions:The incidence of subdelirium syndrome among patients in ICU was high,the patients were prone to progress from subdelirium syndrome to delirium,and clinical nurses had insufficient cognition of subdelirium syndrome.Nurses should strengthen cognition and evaluation on subdelirium syndrome and intervene in time,in order to prevent the occurrence of delirium.