摘要
目的:探讨氧合状态对重症患儿谵妄首次发作的预测价值。方法:2021年10月—2022年3月,采用方便抽样法选取某三级甲等医院289例重症患儿作为研究对象,调查患儿的谵妄发生情况,并探讨氧合指数(PaO_(2)/FiO_(2))对重症患儿谵妄首次发作的预测价值。结果:289例重症患儿PaO_(2)/FiO_(2)为(353.2±108.5) mmHg,谵妄发生率为34.3%;Logistic回归分析显示,PaO_(2)/FiO_(2)、年龄、感染及肾功能异常是预测重症患儿谵妄首次发作风险的因素,PaO_(2)/FiO_(2)可独立解释重症患儿谵妄首次发作34.9%的变异;PaO_(2)/FiO_(2)341.3 mmHg是预测重症患儿谵妄首次发作的最佳临界值,曲线下面积为0.869,灵敏度为0.784,特异度为0.848。结论:氧合状态对重症患儿谵妄首次发作有较高的预测价值,当PaO_(2)/FiO_(2)低于341.3 mmHg时,医护人员应加强对患儿氧合状态的监测并及时采取针对性干预措施,从而降低谵妄发生率。
Objective:To explore the effects of oxygenation status on predicting first onset of delirium among critically ill children.Methods:Totally 289 children in ICU were selected by convenience sampling from October 2021 to March 2022.To investigate the occurrence of delirium in children,and to explore the value of oxygenation index(PaO_(2)/FiO_(2))in predicting the first onset of delirium in severe children Results:Among 289 children in ICU,the overall oxygenation status level was(353.2±108.5)mmHg,the incidence of delirium was 34.26%.Logistic regression analysis showed that PaO_(2)/FiO_(2),age,infection and renal dysfunction were predictive factors for the risk of the first onset of delirium in severely ill children,and PaO_(2)/FiO_(2) could independently explain 34.9%of the variation.PaO_(2)/FiO_(2)341.3 mmHg was the best threshold value for predicting the first onset of delirium in severely ill children.The area under the curve was 0.869,the sensitivity was 0.784,and the specificity was 0.848.Conclusion:Oxygenation status has a high predictive value for the first attack of delirium in critically ill children.It is suggested that when PaO_(2)/FiO_(2) is lower than 341.3 mmHg,medical staff should strengthen the monitoring of children's oxygenation status and take targeted intervention measures in time,so as to reduce the incidence of delirium.
作者
诸葛炜
孟盈彤
许莉莉
戈晓华
ZHUGE Wei;MENG Yingtong;XU Lili;GE Xiaohua(School of Nursing,Shanghai Jiao Tong University,Shanghai 200025 China)
出处
《护理研究》
北大核心
2023年第13期2289-2293,共5页
Chinese Nursing Research
基金
上海市科委基金项目,编号:21511100502
上海交通大学医学院护理学科建设项目资助。
关键词
重症患儿
谵妄
氧合状态
影响因素
预测价值
critically ill children
delirium
oxygenation status
influencing factors
predictive value
