CAJ | 학술논문

目的：谵妄是由多种因素引起的急性器质性脑病综合征。文中探讨老年期谵妄的临床特征、治疗及预后。方法回顾性分析南京军区南京总医院干部病区2011年1月至2013年1月诊断为谵妄的132例老年患者临床资料，按照临床结局分成有效组（痊愈与好转）和死亡组，对患者一般情况、病因、临床特征、治疗等进行总结分析。结果132例患者中男73例，女59例；年龄65～97岁，平均（71．4±8．3）岁。所有患者均有不同程度意识障碍。组间比较发现，有效组与死亡组患者在年龄、谵妄持续时间、病程中是否昏迷、是否重症感染、是否气管插管和（或）气管切开、是否合并有多种基础疾病等方面的差异有统计学意义（P＜0．05）。多因素Logistic回归分析显示，病程中出现昏迷、气管插管和（或）切开、文化程度、体温、合并重症感染是本研究中老年期谵妄患者的独立危险因素（P＜0．05）。结论老年期谵妄治疗过程中应注意患者体温和对感染的控制。针对基础疾病的有效治疗和预防有利于改善患者预后。
목적：섬망시유다충인소인기적급성기질성뇌병종합정。문중탐토노년기섬망적림상특정、치료급예후。방법회고성분석남경군구남경총의원간부병구2011년1월지2013년1월진단위섬망적132례노년환자림상자료，안조림상결국분성유효조（전유여호전）화사망조，대환자일반정황、병인、림상특정、치료등진행총결분석。결과132례환자중남73례，녀59례；년령65～97세，평균（71．4±8．3）세。소유환자균유불동정도의식장애。조간비교발현，유효조여사망조환자재년령、섬망지속시간、병정중시부혼미、시부중증감염、시부기관삽관화（혹）기관절개、시부합병유다충기출질병등방면적차이유통계학의의（P＜0．05）。다인소Logistic회귀분석현시，병정중출현혼미、기관삽관화（혹）절개、문화정도、체온、합병중증감염시본연구중노년기섬망환자적독립위험인소（P＜0．05）。결론노년기섬망치료과정중응주의환자체온화대감염적공제。침대기출질병적유효치료화예방유리우개선환자예후。
Objective To investigate clinical features , outcomes and prognosis gerontol delirium . Methods Patients with gerontol delirium diagnosed between January 2011 and January 2013 were identified by a retrospective review of records in the Nanjing General Hospital of Nanjing Military Command .Totally 132 patients were included , 59 females and 73 males, with a median age of 71.4 years (range 65-97).The diagnostic criteria were based on the DSM-Ⅳ and Delirium Rating Scale.Dementia, depression, mental retardation and other cognitive dysfunction were excluded .General condition of patients , etiology , clinical features , treatment and prognosis were all performed using the SPSS 20.0 for windows.A P value of <0.05 was considered as significant . Results Disturbance of consciousness were observed in all 132 patients.Old age, coma and serious infection in the course , endotracheal intuba-tion and(or) tracheotomy, a variety of basic diseases all come up with poor prognosis . Conclusion Delirium progresses quickly. Etiological treatment can help to control the conditions of delirium .