摘要
目的分析机械通气患者谵妄的发生率、高危因素及预后情况。方法 472例机械通气患者根据是否谵妄分为谵妄组和非谵妄组,采用多因素回归分析谵妄发生的高危因素,采用log-rank检验比较两组患者90 d生存率。结果 472例入选患者中有306例发生谵妄,谵妄发生率为64.83%。高APACHEⅡ评分、机械通气时间延长、高龄及咪达唑仑针镇静是谵妄的危险因素,程序性镇静是谵妄的保护因素。谵妄组90 d生存率为62.75%,非谵妄组为86.75%,两组比较差异具有统计学差异(χ2=15.27,P<0.05)。高反应性谵妄组90 d生存率为77.50%,低反应性和混合性谵妄组生存率为57.52%,两组比较差异具有统计学差异(χ2=8.70,P<0.05)。结论机械通气患者存在较高的谵妄发生率,高APACHEⅡ评分、机械通气时间延长、高龄及咪达唑仑镇静是谵妄发生的危险因素,谵妄会降低患者的生存率。
Objective To investigate the risk factors and prognosis of delirium in patients with mechanical ventilation. Methods Consecutive patients with mechanical ventilation were divided into the delirium group and the non-delirium group. Multivariate logistic regression analysis was used to analyze risk factors of delirium. 90-day survival rate between the two groups was compared by Log-rank test. Results Total 306 cases in 472 cases suffered from delirium, the incidence of delirium was 64.83%. Higher APACHE II score, prolonged mechanical ventilation, older age and midazolam sedation were independent high risk factors of delirium while programmed sedation was the protective factor. 90-day survival rate were 62.75%in the delirium group and 86.75%in the non-delirium group, the difference was statistically significant（χ2=15.27, P〈0.05）. 90-day survival rate were 77.50% in hyperergy delirium group and 57.52% in hypoergia and hybrid delirium groups, the difference was statistically significant （χ2=8.70,P〈0.05）. Conclusion The incidence rate of delirium is rela-tively higher in patients with mechanical ventilation. Higher APACHE Ⅱ score, prolonged mechanical ventilation, older age and midazolam sedation were independent high risk factors of delirium. 90-day survival rate would be decreased by delirium.
出处
《全科医学临床与教育》
2014年第6期645-648,共4页
Clinical Education of General Practice
基金
台州恩泽基金项目编号(EZ2013D04)
关键词
谵妄
机械通气
高危因素
预后
delirium
mechanical ventilation
risk factor
prognosis
