肾移植术后监护期出现谵妄临床分析及应对措施.doc

肾移植术后监护期出现谵妄临床分析及应对措施 　　[摘要] 目的 探讨肾移植术后监护期出现谵妄的临床分析及应对措施。方法 方便?x取该院2013年1月―2016年6月肾移植术后于监护期进行抗排斥治疗34例患者为研究对象，运用ICU 患者意识模糊评估法（Confusion Assessment Method for Intensive Care Unit，CAM-ICU CAM-ICU）对移植术后监护期抗排斥治疗的患者进行谵妄的评估，筛选出谵妄患者，并根据谵妄的临床症状和病因分析进行药物与非药物的应对措施。 结果 肾移植术后于监护期进行抗排斥治疗34例患者中有14.71%（5/34）出现谵妄，分析其原因，由疾病因素引起的有8.82%（3/34），由药物和环境因素引起各2.94%（1/34），疾病因素相比，差异无统计学意义（P0.05）；根据出现谵妄的原因给予疾病治疗、使用镇静药、停药或加药、半开放探视等应对措施均使谵妄好转。结论 CAM-ICU能有效的对谵妄进行评估，对肾移植术后监护期的患者给予护理干预措施，可以减少谵妄等并发症的发生，促进患者恢复健康 [关键词] 肾移植；谵妄；CAM-ICU；病因 [中图分类号] R5 [文献标识码] A [文章编号] 1674-0742（2016）12（b）-0140-037 Clinical Analysis and Countermeasures of Delirium Monitoring Period Appeared After Renal Transplantation ZHENG Rui Guangdong General Hospital Oral Renal Transplantation（Guangdong Academy of Medical Sciences）， Guangzhou， Guangdong Province，510080 China [Abstract] Objective Clinical analysis and countermeasure study of delirium monitoring period after renal transplantation. Methods In our hospital from January 2013 to June 2016，Convenient selection 34 patients were treated with anti rejection therapy after kidney transplantation. Fuzzy evaluation method with ICU （Confusion Assessment Method for Intensive consciousness Care Unit， CAM-ICU CAM-ICU） for the assessment of delirium after transplantation monitoring period of anti rejection therapy patients， selected patients with delirium， and analysis of drug and non drug measures according to clinical symptoms and causes of delirium. Results After renal transplantation in the monitoring period of anti rejection therapy in 34 cases， 14.71%（5/34） delirium， analyse the reasons caused by the disease factor 8.82% （3/34）， the 2.94% caused by drug and environmental factors （1/34）， disease factors compared， no significant difference （P0.05）； According to the causes of delirium to disease treatment， the use of sedative drugs， semi open withdrawal or dosing， measures such as the visitation of delirium better. Conclusion CAM-ICU can effectively evaluate the deliri