ICU老年肺癌患者术后谵妄影响因素分析

目的 探讨ICU老年肺癌患者术后谵妄的影响因素。方法 收集2019年9月至2020年5月上海市胸科医院收治的208例老年肺部肿瘤手术患者术后谵妄发生情况。采用ICU患者意识模糊评估法（CAM-ICU）量表，观察患者术后谵妄发生情况；采用中文版重症监护室患者睡眠质量量表（Richards-Campbell sleep questionaire, RCSQ）量表，观察患者术后睡眠质量；采用术前简易心理状态检查（mini-mental state examination,MMSE）量表观察患者术前认知水平。通过单因素和logistic回归分析明确ICU老年肺癌患者术后谵妄的影响因素。结果 共纳入208例患者，32例（15.38%）发生谵妄，176例（84.62%）未发生谵妄。纳入22个变量，包括术前变量11个和术后变量11个，其中低氧（≤60 mmHg）、冠心病史、镇静药物使用史是肺癌术后ICU老年患者谵妄诱发的危险因素。Logistic回归分析显示，RCSQ量表得分高于20分的患者较低于20分的患者，其谵妄发生的风险明显降低（P<0.05）。MMSE量表得分高于27分的患者较低于27...

Analysis of influencing factors of postoperative delirium in elderly patients with lung cancer in ICU

Objective: To investigate the influencing factors of postoperative delirium in elderly patients in ICU with lung cancer. Methods: The incidence of postoperative delirium was investigated in the elderly patients with lung cancer who were admitted to the Intensive Care Department of our hospital from September 2019 to May 2020. The incidence of postoperative delirium was observed by using the ICU patient fuzzy Consciousness assessment (CAM-ICU) scale. The Chinese version of the Richards-Campbell Sleep Questionaire (RCSQ) scale was used to observe the sleep quality of patients after surgery. Mini-Mental State Examination (MMSE) scale was used to observe the preoperative cognitive status of patients. The influencing factors of postoperative delirium in elderly patients with lung cancer in ICU were determined by univariate and Logistic regression analysis.Results: A total of 208 patients were included in this study, of which 32 developed delirium (15.38%) and 176 did not (84.62%). Twenty-two variables were included, including 11 preoperative variables and 11 postoperative variables, among which hypoxia (< 60 mmHg), history of coronary heart disease, and history of sedation were risk factors for delirium in ICU elderly patients after lung cancer surgery. Meanwhile, Logistic regression analysis showed that patients who scored more than 20 points in the Chinese version of the Richards-Campbell Sleep Questionaire (RCSQ) had significantly lower risk of delirium than those who scored less than 20 points. Patients whose preoperative Mini-Mental State Examination (MMSE) score was higher than 27 had significantly lower risk of delirium than patients whose score was lower than 27. Conclusions: The incidence of postoperative delirium in elderly patients with lung cancer in ICU is not low. The incidence of clinical delirium can be reduced and the clinical outcome can be improved by effectively identifying the risk factors of delirium.