CAJ | 학술논문

目的：探讨重症监护室（ICU）危重症患者谵妄的主要原因，为减少 ICU 危重症患者谵妄的发生提供临床参考。方法选取 ICU 收治的431例危重症患者为研究对象，入院后根据病情进行治疗，观察是否发生谵妄，分析发生谵妄的相关原因。结果431例患者发生谵妄者93例，谵妄发生率21.58%。患者年龄>60岁、初中及以下、使用硝普钠、使用咪唑安定、发热、低血压或心源性休克、电解质紊乱、有机械通气、感染、高血压、糖尿病时谵妄发生率明显增高，差异具有统计学意义（ P <0.05）；多因素 Logistic 回归分析显示文化程度低、发热、低血压或心源性休克、电解质紊乱、机械通气、感染、高血压、糖尿病是引起患者发生谵妄的独立危险因素（ P <0.05）。结论 ICU 危重症患者谵妄发生率高，患者文化程度低、发热、低血压或心源性休克、电解质紊乱、机械通气、感染、高血压、糖尿病是引起谵妄发生的主要原因，应针对以上因素积极进行治疗以减少谵妄发生。
목적：탐토중증감호실（ICU）위중증환자섬망적주요원인，위감소 ICU 위중증환자섬망적발생제공림상삼고。방법선취 ICU 수치적431례위중증환자위연구대상，입원후근거병정진행치료，관찰시부발생섬망，분석발생섬망적상관원인。결과431례환자발생섬망자93례，섬망발생솔21.58%。환자년령>60세、초중급이하、사용초보납、사용미서안정、발열、저혈압혹심원성휴극、전해질문란、유궤계통기、감염、고혈압、당뇨병시섬망발생솔명현증고，차이구유통계학의의（ P <0.05）；다인소 Logistic 회귀분석현시문화정도저、발열、저혈압혹심원성휴극、전해질문란、궤계통기、감염、고혈압、당뇨병시인기환자발생섬망적독립위험인소（ P <0.05）。결론 ICU 위중증환자섬망발생솔고，환자문화정도저、발열、저혈압혹심원성휴극、전해질문란、궤계통기、감염、고혈압、당뇨병시인기섬망발생적주요원인，응침대이상인소적겁진행치료이감소섬망발생。
Objective To explore the main causes of delirium in critical patients in intensive care unit(ICU)in order to reduce the oc-currence of delirium in critical patients of ICU and to provide clinical reference. Methods The clinical data of 431 critical patients in ICU were collected for this study according to the method of treatment for illness after admission,and the related causes for occurrence of delirium were also observed and analyzed. Results Among these 431 patients,delirium had been occurred in 93 cases,and the incidence of delirium was 21. 58% . Patients with age > 60 years old and education at junior high school level,usually administrated with sodium nitrate and imidazole,and accompa-nied with fever,low blood pressure or cardiogenic shocK,electrolyte disorder,mechanical ventilation,infection,hypertension and/ or diabetes were significantly higher in incidence of delirium,and the difference with other patients was statistically significant( P < 0. 05). Multivariate Lo-gistic regression analysis showed that low degree of culture,fever,low blood pressure and cardiogenic shocK,electrolyte disorder,mechanical ven-tilation,infection,hypertension and diabetes were independent risK factors responsible for occurrence of delirium in these patients( P < 0. 05). Conclusion The causes for high incidence of delirium in critically ill patients in ICU are low degree of culture,complicated with fever,low blood pressure,cardiogenic shocK,electrolyte disorder,mechanical ventilation,infection,hypertension and/ or diabetes are major causes for occurrence of delirium,hence patients with above risK factors in ICU should be actively treated in order to reduce the occurrence of delirium.