高血压脑出血术后谵妄现状调查和影响因素分析

Study on the status and influencing factors of delirium after operation of hypertensive cerebral hemorrhage

目的探讨分析高血压脑出血患者手术后谵妄发生情况及其可能的影响因素。方法选取本院2017年10月~2019年10月收治的100例高血压脑出血手术患者作为研究对象,以自拟问卷来调查患者术后谵妄发生情况和可能的影响因素。结果100例高血压脑出血患者经过手术治疗后,有30例发生谵妄,发生率高达30.00%。Logistic多元回归分析发现,脑出血量、手术操作时长、患者年龄、术后低氧血症、术后格拉斯哥昏迷指数量表(GCS)评分可能为高血压脑出血术后患者发生谵妄的独立风险因素(P<0.05),而呼吸机辅助通气可能为高血压脑出血术后患者发生谵妄的保护因素(P<0.05)。谵妄患者三个月存活率53.33%低于术后无谵妄患者存活率85.71%(P<0.05)。结论高血压脑出血患者手术后谵妄发生率较高,存活率降低,考虑与多种影响因素相关,可为临床有效干预提供指导。

Objective To analyze the status and influencing factors of delirium after operation of hypertensive cerebral hemorrhage.Methods A total of 100 patients with hypertensive cerebral hemorrhage admitted to our hospital from October 2017 to October 2019 were selected as research objects,and a self-designed questionnaire was used to investigate the occurrence and possible influencing factors of postoperative delirium.Results Delirium occurred in 30 of the 100 patients with hypertensive cerebral hemorrhage after surgical treatment,with an incidence of 30.00%.Logistic multivariate regression analysis found that cerebral hemorrhage,and length of operation,age,postoperative hypoxemia,GCS score may be independent risk factors for delirium after operation of hypertensive cerebral hemorrhage(P<0.05),while breathing machine auxiliary ventilation may be protective factors for delirium after operation of hypertensive cerebral hemorrhage(P<0.05).The 3-month survival rate of delirium patients was 53.33%lower than 85.71%of delirium free patients(χ^(2)=7.556,P<0.05).Conclusion The incidence of postoperative delirium in patients with hypertensive cerebral hemorrhage was higher and the survival rate was lower,which could provide guidance for effective clinical intervention.