无抽搐电休克治疗术后谵妄危险因素分析

Study of risk factors of delirium after modified electroconvulsive therapy

目的探讨精神疾病患者无抽搐电休克治疗(modified electroconvulsive therapy,MECT)术后谵妄发生的危险因素。方法纳入接受MECT治疗的1001例精神疾病患者,收集一般人口学资料、临床特征、MECT治疗参数、脑电监测中的抽搐发作情况、术后谵妄发生情况等,对谵妄发生的相关危险因素进行分析。结果1001例接受MECT治疗的精神疾病患者中,发生谵妄者102例(10.2%)。logistic回归分析示抽搐发作时间长(OR=1.037)、低氧血症(OR=9.052)、共患高血压(OR=6.564)与术后谵妄发生相关(P<0.01)。抽搐发作时间≥70 s者术后谵妄发生率(46.7%)显著高于其他抽搐发作时间者(P<0.01)。结论抽搐发作时间长、低氧血症、共患高血压是精神疾病患者MECT术后谵妄发生的危险因素。

Objective To explore the risk factors of delirium after modified electroconvulsive therapy(MECT).Methods A total of 1001 patients with psychosis with MECT were included.Data including demographic information,clinical characteristics,MECT parameters,seizure duration in EEG monitoring and delirium or not after MECT were recorded and analyzed to investigate the risk factors for delirium.Results Delirium occurred in 102 cases of 1001 patients with psychosis who received MECT and the incidence was 10.2%.Logistic regression analysis showed that long seizure duration(OR=1.037),hypoxemia(OR=9.052)and comorbid hypertension(OR=6.564)were risk factors for delirium after MECT(P<0.01).The incidence of delirium(46.67%)increased significantly with seizure duration at 70 seconds or longer(P<0.01).Conclusion Long seizure time,hypoxemia and comorbid hypertension are risk factors of delirium after MECT.