睡眠质量,昼夜节律稳定性和妄状态的变化,预测重症监护室患者的死亡风险:一项前性观察研究
Hui-Ju Lai1, Wen-Pei Chang1,2
1Department of Nursing, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
Nursing in critical care
|November 17, 2025
概括
在重症监护室 (ICU) 患者的睡眠质量差和昼夜节律受损与妄想症和死亡风险增加有关. 监测睡眠和昼夜模式可以帮助早期干预并改善患者的治疗结果.
科学领域:
- 关键护理医学 关键护理医学
- 神经科学是一个神经科学.
- 睡眠医学 睡眠医学
背景情况:
- 痴呆症是重症监护室 (ICU) 中常见且具有预后意义的神经精神疾病并发症.
- 了解影响狂妄症发展和结果的因素对于改善患者护理至关重要.
研究的目的:
- 为了研究睡眠质量和昼夜节律稳定性之间的关联,通过动图测量,以及ICU患者的妄想状态.
- 评估这些睡眠和昼夜参数对ICU患者死亡风险的预测价值.
主要方法:
- 一项前性观察性研究,涉及74名成年ICU患者72小时.
- 动图法用于测量总睡眠时间 (TST),睡眠开始后醒来 (WASO) 和昼夜节律稳定性 (r24).
- 用ICU (CAM-ICU) 的混评估方法评估 Delirium,并将其分类为没有 Delirium,长期或新发病.
主要成果:
- 与没有妄想症 (13.3%) 患者相比,患有长期妄想症 (45%) 和新发妄想症 (45%) 的患者的死亡率明显高.
- 较低的昼夜节律稳定性 (r24) 与长期妄有关,而增加的WASO与长期和新发妄有关.
- 多变量分析确定了长期妄和SOFA分数作为死亡率的独立预测指标.
结论:
- 睡眠连续性 (WASO) 和昼夜节律稳定性 (r24) 与ICU患者的妄想状态变化密切相关.
- 较低的r24预测了长时间的妄想和较高的死亡率,而较高的WASO与新发作妄想有关.
- 建议持续监测睡眠和昼夜节律,将WASO纳入风险评估,以便及时进行干预并改善ICU护理质量.
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