[肝移植后 Delirium 的风险因素和预后]
Ying Ma1, Wei-Ting Peng2, Jing Liu1
1Transplantation Center, Third Xiangya Hospital, Central South University, Changsha 410013, China.
概括
痴呆症发生在20.4%的肝移植 (LT) 患者中,通常发生在手术后19小时内. 手术前感染,高MELD得分和肝脏脑病是关键的危险因素,而卡巴因的使用可能具有保护作用.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 移植手术 移植手术
- 神经临界护理是指神经临界护理.
背景情况:
- 痴呆症是肝移植 (LT) 后的常见和严重并发症.
- 了解LT后妄想的发生率,时间和风险因素对于患者的治疗和结果至关重要.
研究的目的:
- 为了确定肝移植后 Delirium 的发生率和发病时间.
- 为了确定与LT接受者的术后妄想相关的独立风险因素和保护因素.
- 分析妄想对临床结果的影响,特别是ICU停留时间.
主要方法:
- 从2019年1月至2021年12月期间接受LT的211名患者的临床数据的回顾性分析.
- 使用描述性统计数据调查妄想发病率和发病时间.
- 应用单变量和多变量逻辑回归来识别风险因素和分析临床结果.
主要成果:
- 妄想发作的发生率为20.4% (43/211),中位数发病时间为LT后19小时.
- 妄的独立风险因素包括手术前感染,高末期肝病模型 (MELD) 评分 (≥22) 和手术前肝脏脑病.
- 卡巴胺抗生素使用≥3天被确定为预防狂妄症的保护因素,狂妄症与术后ICU停留时间较长有关.
结论:
- 手术后妄是常见的,发生在肝移植后的早期.
- 手术前感染,MELD得分升高和肝脏脑病是 Delirium 的重要危险因素.
- 碳胺使用可以作为预防措施,妄会对术后恢复产生负面影响,其证据是急症监护室停留时间增加.
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