摘要
目的:探讨急性心肌梗死(AMI)(PCI)术后谵妄的危险因素。方法:选择2017年12月-2019年12月145例AMI患者为研究对象,术后评估患者谵妄发生情况并设为谵妄组与非谵妄组,收集年龄、合并症、性别等一般资料,调查术后视觉模拟(VAS)疼痛评分以及焦虑自评量表(SAS)等,组间先进行单因素分析,差异具有统计学意义的变量再赋值并进行多因素Logistic回归分析。结果:145例AMI患者PCI术后共发生谵妄35例,发生率24.14%;经单因素与多因素Logistic回归分析调查显示,睡眠障碍(OR=2.443,95%CI=1.181~7.291,P<0.05)、低氧血症(OR=3.279,95%CI=1.642~11.270,P<0.05)、手术时间>90min(OR=2.238,95%CI=1.445~7.201,P<0.05)、焦虑(OR=3.023,95%CI=2.023~9.592,P<0.05)、低钾血症(OR=2.882,95%CI=1.832~9.034,P<0.058)、疼痛VAS评分≥7分(OR=2.201,95%CI=1.112~6.361,P<0.05)、发生心脏骤停(OR=2.854,95%CI=1.554~7.876,P<0.05)是AMI患者PCI术后谵妄的独立危险因素。结论:AMI患者PCI术后谵妄发生率较高,危险因素包括睡眠障碍、低氧血症、低钾血症、手术时间长、严重疼痛、发生心脏骤停等,应重视相关危险因素,采取相应措施预防谵妄发生。
Objective:To explore the risk factors for delirium after acute myocardial infarction(AMI)percutaneous coronary intervention(PCI).Methods:A total of 145 patients with AMI from December 2017 to December 2019 were selected as the study subjects.Postoperatively,the occurrence of delirium in patients were assessed and set to the delirium group and the non-delirium group.The general information such as age,comorbidities,gender were collected.The postoperative visual simulation(VAS)pain score and anxiety self-rating scale(SDS)were investigated.Univariate analysis was conducted between groups,and variables with statistically significant differences were assigned and multivariate logistic regression analysis was performed.Results:Of the 145 AMI patients,35 cases of delirium occurred after PCI,the incidence rate was 24.14%.Through single factor and multi-factor logistic regression analysis investigations,sleep disorders(OR=2.443,95%CI=1.181~7.291,P<0.05),hypoxemia(OR=3.279,95%CI=1.642~11.270,P<0.05),operation time>90 min(OR=2.238,95%CI=1.445~7.201,P<0.05),anxiety(OR=3.023,95%CI=2.023~9.592,P<0.05),hypokalemia(OR=2.882,95%CI=1.832~9.034,P<0.05),pain VAS score≥7 points(OR=2.201,95%CI=1.112~6.361,P<0.05),cardiac arrest(OR=2.854,95%CI=1.554~7.876,P<0.05)were independent risk factors for delirium after PCI in AMI patients.Conclusion:AMI patients have higher incidence of delirium after PCI,risk factors include sleep disturbance,hypoxemia,hypokalemia,long operation time,severe pain,cardiac arrest.Attention should be paid to relevant risk factors and corresponding measures should be taken to prevent delirium.
作者
郝献芳
刘筱咏
邬海燕
王倩
蔡巧珍
HAO Xianfang;LIU Xiaoyong;WU Haiyan(Department of Cardiology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)
出处
《中国健康心理学杂志》
2020年第12期1802-1805,共4页
China Journal of Health Psychology
基金
2018年度河南医学科技攻关计划项目(编号:2018020923)。
关键词
急性心肌梗死
经皮冠状动脉介入术
谵妄
危险因素
Acute myocardial infarction
Percutaneous coronary intervention
Delirium
Risk factors
