急诊重症监护病房患者精神障碍的监测

目的:探讨急诊重症监护病房(emergency intensive care unit,EICU)患者精神障碍的临床特征。方法:收集2010年1月至2012年1月2年间,于北京安贞医院EICU住院患者的临床资料,进行总结分析。结果:患者住EICU出现精神障碍的年龄段集中在76～85岁,占57.1%(P<0.05),发生率7.5%(42/563),男女病死率相同11.9%(5/42)。患者基础病多为呼吸系统、心血管系统疾病、营养和代谢疾病,常合并呼吸衰竭、心力衰竭、电解质紊乱及肾功能不全等。EICU患者精神障碍的临床表现多为行为异常和定向力障碍。出现EICU精神障碍的患者精神症状大多持续1～10 d;由疾病因素为主导致精神障碍占61.9%(26/42),由非疾病因素为主导致的精神障碍占38.1%(16/42)。结论:EICU患者精神障碍的发生率以及病死率高。出现精神障碍多数与基础疾病有关。应重视病因治疗减少精神障碍持续时间。

Mental disorders monitoring of patients in emergency intensive care unit

Objective:To assess the clinical feature of patients with mental disorders in emergency intensive care unit.Methods: Patients data were collected from Beijing Anzhen Hospital Emergency intensive care unit(EICU) between January 2010 and January 2012.Patient details were systematically reviewed and analysed.Results: Firstly,we found that the incidence of EICU patients with mental disorder was 7.5%(42/563).57.1%(P<0.05)of these patients were between the age of 76～85.The risk of mortality was 11.9%(5/42).However,there were no significant differences between genders.Secondly,we found that majority of our patient had respiratory disease,cardiovascular disease,nutrition and metabolism disorders,respiratory failure,cardiac failure,cardiac arrhythmia,and renal failure.Thirdly,EICU patients with mental disorder usually present with behavior problem or focal neurological deficit.Finally,these symptoms with mental disorder usually continued for 1-10d;The patients with mental disorder mainly by disease factors accounted for 61.9%(26/42),The patients with mental disorder mainly by non-disease factors accounted for 38.1%(16/42).Conclusion:EICU patients with mental disorder exhibited higher morbidity and mortality.The majority of mental disorders related to the underlying disease.Should pay attention to the cause of treatment to reduce the duration of the mental disorders.