先天性心脏病患儿术后谵妄危险因素的前瞻性巢式病例对照研究

doi:10.7499/j.issn.1008-8830.2110026

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摘要目的探讨儿童先天性心脏病术后谵妄的危险因素。方法选取2020年12月至2021年6月于中国医学科学院阜外医院完成先天性心脏病外科手术的患儿进行前瞻性巢式病例对照研究。将术后谵妄组（n=114）和非谵妄组（n=102）的临床资料进行比较，应用多因素非条件logistic回归分析探索先天性心脏病患儿术后谵妄的危险因素。结果多因素logistic回归分析显示，年龄（OR=0.951，P<0.001）、性别（OR=2.127，P=0.049）、每日有创导管留置数量（OR=1.490，P=0.017）、术后疼痛程度（OR=5.856，P<0.001）、术前陪护家长焦虑程度（OR=1.025，P=0.010）是先天性心脏病患儿术后谵妄的独立影响因素。结论年龄越小、男性、每日有创导管留置数量越多、术后疼痛程度越高、术前陪护家长焦虑程度越高的先天性心脏病患儿，发生术后谵妄的风险越高。

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	吕娟
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关键词 ：术后谵妄, 先天性心脏病, 危险因素, 儿童

Abstract：Objective To study the risk factors for postoperative delirium (POD) in children with congenital heart disease. Methods A prospective nested case-control study was performed on children with congenital heart disease who underwent surgery in Fuwai Hospital, Chinese Academy of Medical Sciences, from December 2020 to June 2021. The clinical data were compared between the POD group (n=114) and non-POD group (n=102). A multivariate unconditional logistic regression analysis was used to investigate the risk factors for POD in children with congenital heart disease. Results The multivariate logistic regression analysis showed that age (OR=0.951, P<0.001), gender (OR=2.127, P=0.049), number of invasive catheters per day (OR=1.490, P=0.017), degree of postoperative pain (OR=5.856, P<0.001), and preoperative parental anxiety level (OR=1.025, P=0.010) were independent risk factors for POD in children with congenital heart disease. Conclusions The risk of POD increases in children with congenital heart disease who are younger, male, have higher number of invasive catheters per day, higher degree of postoperative pain, or higher preoperative parental anxiety level.

Key words： Postoperative delirium Congenital heart disease Risk factor Child

收稿日期: 2021-10-09

通讯作者: 李杨，女，教授。Email：liyang3413@sina.com。 E-mail: liyang3413@sina.com

作者简介: 吕娟，女，硕士研究；

引用本文:

吕娟,贾艳,阎曚等. 先天性心脏病患儿术后谵妄危险因素的前瞻性巢式病例对照研究[J]. 中国当代儿科杂志, 2022, 24(3): 232-239.

LYU Juan,JIA Yan,YAN Meng et al. Risk factors for postoperative delirium in children with congenital heart disease: a prospective nested case-control study[J]. CJCP, 2022, 24(3): 232-239.

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