摘要
目的调查脓毒症患者认知功能障碍的危险因素,为认知功能障碍的针对性预防提供临床依据。方法选择2019年1月~2021年1月我院收治的104例脓毒症存活患者,调查生命体征稳定后1周内认知功能障碍发生情况。比较认知功能障碍患者与没有的患者在年龄、性别、合并症等的差异,采用单因素与二元logistic回归分析调查脓毒症患者认知功能障碍危险因素。结果104例脓毒症患者中40例发生认知功能障碍;认知功能障碍组与非认知功能障碍组在年龄、谵妄持续时间、脓毒症严重程度、合并低氧血症、苯二氮艹卓类药物使用史、高血糖、急性生理功能和慢性健康状况评分系统Ⅱ(APACHEⅡ)评分、序贯器官衰竭评分(SOFA)、机械通气时间方面有统计学意差异义(P<0.05);两组在性别、ICU住院时间、受教育年限差异无统计学意义(P>0.05);二元logistic回归分析显示,年龄≥60岁、谵妄持续时间、脓毒性休克、合并低氧血症、苯二氮艹卓类药物使用史、合并高血糖是脓毒症患者认知功能障碍危险因素。结论脓毒症存活患者具有较高的认知功能障碍发生率,危险因素包括年龄、谵妄、脓毒性休克等,应根据危险因素采取针对性干预措施以期降低认知功能障碍发生率。
Objective To investigate the risk factors of cognitive dysfunction in patients with sepsis and provide a theoretical basis for the prevention of cognitive dysfunction.Methods A total of 84 surviving patients with sepsis from January 2019 to January 2021 were selected to investigate the occurrence of cognitive dysfunction within 1 week after the vital signs were stabilized.The age,gender,comorbidities and other medical records were compared between patients with cognitive dysfunction and without cognitive dysfunction.Single factor and binary logistic regression analysis were used to investigate the risk factors of cognitive dysfunction in patients with sepsis.Results 40 cases occurred cognitive dysfunction in 104 patients with sepsis.There were significantly different on age,duration of delirium,severity of sepsis,combined hypoxemia,history of benzodiazepine use,hyperglycemia,years of education,acute physiological function and chronic health score SystemⅡ(APACHEⅡ)score,sequential organ failure score(SOFA),and mechanical ventilation time between patients with cognitive dysfunction and without cognitive dysfunction(P<0.05).There was no significant difference between the two groups in gender,length of ICU hospitalization,and years of education(P>0.05).Binary logistic regression analysis showed that age>60 years,duration of delirium,septic shock,combined with hypoxemia,history of benzodiazepine use,and combined with hyperglycemia were risk factors for cognitive dysfunction in patients with sepsis.Conclusion Surviving patients with sepsis have a higher incidence of cognitive dysfunction.Risk factors include age,delirium,septic shock,etc.,and targeted intervention measures should be taken according to the risk factors to reduce the incidence of cognitive dysfunction.
作者
张实秋
ZHANG Shiqiu(ICU,Zhoukou Central Hospital,Zhoukou 466000,China)
出处
《国际精神病学杂志》
2022年第4期713-716,共4页
Journal Of International Psychiatry
