摘要
目的：通过评分系统分析患者ICU谵妄发生的危险因素。方法对440例患者分别在入ICU即刻与出ICU时应用焦虑自评量表（ SAS）、抑郁自评量表（ SDS）及ICU谵妄筛查表（ ICDSC）进行评价，同时记录发生ICU综合征的各种可能危险因素及入ICU及出ICU时的急性生理与慢性健康评分（ APACHEⅡ）。分别对危险因素与出ICU时SAS、SDS及ICDSC评分的关系进行多元线性回归分析。结果患者转出ICU后，APACHE Ⅱ评分、SAS、SDS及ICDSC各项评分分别为（9．8±3．2），（43．8±11.3），（43．1±10．8）与（2．43±2．00）分，进入ICU时分别为（17．3±5．5），（48．3±12．7），（48．5±12.3），（1．36±0．81）分，差异有统计学意义（t值分别为7．549，3．004，3．780，－3．329；P＜0．05）。逐步多元回归分析显示，SAS评分与住院天数、出院 APACHE Ⅱ评分、引流管数量相关（R2＝0．515，F ＝14.139，P＜0．001）；SDS评分与住院天数、引流管数量相关（R2＝0．444，F＝16．395，P＜0．001）；ICDSC评分与文化程度、住院天数、机械通气时间、出院APACHE Ⅱ评分相关（ R2＝0．803，F＝39．769，P ＜0.001）。结论 ICDSC诊断ICU谵妄的敏感性较高，可用于ICU谵妄的筛查。随着住ICU天数的增加，发生ICU谵妄的可能性增加。
Objective To evaluate the risk factors of delirium in patients of intensive care unit （ ICU） by different scale systems.Methods Totals of 440 patients were enrolled in this investigation.Self-Rating Anxiety Scale （SAS）, Self-Rating Depression Scale （SDS） and Intensive Care Delirium Screening Checklist （ ICDSC） were used when patients in-and out-ICU.Other risk factors and APACHE Ⅱ score were recorded. Multiple linear regression was done between each scale and all risk factors.Results The scores of APACHEⅡ, SAS,SDS and ICDSC were （9.8 ±3.2）, （43.8 ±11.3）, （43.1 ±10.8） and （2.43 ±2.00） when patients discharged from ICU.Those values were （17.3 ±5.5）, （48.3 ±12.7）, （48.5 ±12.3） and （1.36 ±0.81） when patients first admitted to ICU.There were significant differences （ t =7.549,3.004,3.780,-3.329, respectively;P〈0.05）.Multiple linear regression analysis showed that the score of SAS was correlated with duration in ICU, APACHEⅡscore and drainage catheter amount （R2 =0.515,F=14.139,P〈0.001）.The score of SDS was correlated with duration in ICU and drainage catheter amount （ R2 =0.444,F=16.395,P〈0.001） .The score of ICDSC was correlated with education, duration in ICU, duration of mechanical ventilation and APACHEⅡscore （R2 =0.803,F=39.769,P〈0.001）.Conclusions The sensitivity of ICDSC is high and can be used to screen delirium in ICU.The incidence of delirium increases with the duration of ICU stays.
出处
《中华现代护理杂志》
2015年第2期134-137,共4页
Chinese Journal of Modern Nursing
