CAJ | 학술논문

分析主动脉夹层术后出现谵妄的危险因素。方法回顾性分析106例急性主动脉夹层A型患者的术后临床资料，筛选术后谵妄的危险因素并用 logistic 回归分析。结果单因素分析显示，主动脉阻断时间(P <0.01)、体外循环时间(P<0.05)、术后急性生理和慢性健康Ⅱ(APACHE Ⅱ)评分(P <0.05)、术后最低氧合指数(P<0.01)、有创通气时间(P<0.01)、是否应用吗啡(P<0.05)在谵妄与非谵妄患者之间差异有统计学意义，将上述单因素分析差异有统计学的变量进行二分类logistic回归分析，结果表明，主动脉阻断时间(P<0.05)、术后最低氧合指数(P<0.05)、有创通气时间(P<0.05)均是术后谵妄发生的危险因素。谵妄延长住 ICU 时间，但对住院时间无影响。结论加强心理疏导，减少手术主动脉阻断时间、改善术后氧合情况、缩短机械通气时间可预防术后谵妄的发生，缩短住 ICU时间。
분석주동맥협층술후출현섬망적위험인소。방법회고성분석106례급성주동맥협층A형환자적술후림상자료，사선술후섬망적위험인소병용 logistic 회귀분석。결과단인소분석현시，주동맥조단시간(P <0.01)、체외순배시간(P<0.05)、술후급성생리화만성건강Ⅱ(APACHE Ⅱ)평분(P <0.05)、술후최저양합지수(P<0.01)、유창통기시간(P<0.01)、시부응용마배(P<0.05)재섬망여비섬망환자지간차이유통계학의의，장상술단인소분석차이유통계학적변량진행이분류logistic회귀분석，결과표명，주동맥조단시간(P<0.05)、술후최저양합지수(P<0.05)、유창통기시간(P<0.05)균시술후섬망발생적위험인소。섬망연장주 ICU 시간，단대주원시간무영향。결론가강심리소도，감소수술주동맥조단시간、개선술후양합정황、축단궤계통기시간가예방술후섬망적발생，축단주 ICU시간。
Objective To analyze the risk factors of delirium following acute aortic dissection surgery.Methods The clinical data of 106 patients undergoing acute aortic dissection type Ⅰ surgery at our hospital were retrospectively analyzed for the risk factors of delirium.Binary logistic regression model was used to assess the affection of factors.Results Univariate analysis showed that aortic clamping time (P <0.01 ),cardiopulmonary bypass time (P <0.05),postoperative APACHE Ⅱ score (P <0.05),the lowest postoperative oxygenation index (P <0.01),invasive ventilation time (P <0.01),whether morphine (P <0.05)between delirium and delirium patients were significantly different,the above variables into binary Logistic regression analysis showed that aortic clamp time (P<0.05),the lowest postoperative oxygenation index (P<0.05),invasive ventilation time(P<0.05) were risk factors for postoperative delirium.Delirium prolonged ICU stay,but had no effect on the length of hospital stay.Conclusion Strengthening psychological counseling, reducing surgical aortic clamping time,improving oxygenation and shorter duration of mechanical ventilation can prevent the occurrence of postoperative delirium, simultaneously shorten ICU stay.