患儿术后谵妄影响因素的研究进展

doi:10.16460/j.issn1008-9969.2024.09.032

摘要/Abstract

摘要： 目的综述患儿术后谵妄的影响因素研究进展,为降低其术后谵妄发生率提供参考依据。方法检索国内外主题相关的实验研究、论文、指南等文献,总结患儿术后谵妄影响因素的研究进展。结果年龄、身体发育营养、疾病、手术类型、麻醉方式、围术期用药、术后疼痛、长时间的机械通气、呼吸机并发症与术后并发症等,均是患儿术后谵妄的影响因素。结论掌握上述的患儿术后谵妄的10项影响因素,从自身因素、医源性因素和其他因素等角度,完善术后谵妄评估机制,对高危因素患儿进行预防与干预,从而促进其术后康复。

关键词: 儿童, 谵妄, 手术后, 影响因素

中图分类号:

R473.72

陈莹莹, 丁红, 张根生. 患儿术后谵妄影响因素的研究进展[J]. 护理学报, 2024, 31(9): 32-35.

参考文献

[1] Dahmani S, Delivet H, Hilly J.Emergence delirium in children:an update[J].Curr Opin Anaesthesiol,2014,27(3):309-315.DOI:10.1097/ACO.0000000000000076.
[2] Bryant KJ.Pediatric delirium in the cardiac intensive care unit: identification and intervention[J]. Crit Care Nurse,2018,38(4):e1-e7.DOI:10.4037/ccn2018947.
[3] Leroy PL, Schieveld JNM.Mind the heart: delirium in children following cardiac surgery for Congenital Heart Disease[J].Pediatr Crit Care Med, 2017, 18(2):196-198. DOI: 10.1097/PCC.0000000000001038.
[4] Aldecoa C, Bettelli G, Bilotta F, et al. European Society of Anaesthesiology evidence-based and consensus-based guideline on postoperative delirium[J]. Eur J Anaesthesiol, 2017,34(4):192-214. PMID:28187050.DOI:10.1097/EJA.0000000000000594.
[5] 刘柯显,徐红贞.小儿术后谵妄影响因素的研究进展[J].解放军护理杂志, 2020, 37(10):61-64. DOI:10.3969/j.issn.1008-9993.2020.10.015.
[6] 钱素云,张崇凡.危重症儿童营养评估及支持治疗指南(2018,中国)解读(1)[J].中国循证儿科杂志,2018,13(1):32-34.DOI: 10.3969/j.issn.1673-5501.2018.01.003.
[7] Kalvas LB.The Life Course Health Development Model:a theoretical research framework for paediatric delirium[J]. J Clin Nurs, 2019, 28(11/12):2351-2360. DOI: 10.1111/jocn.14776.
[8] 林楠,刘柯显,冯静怡,等.儿童术后谵妄发生现状及危险因素分析[J].中华危重症医学杂志(电子版),2021,14(5):386-392. DOI:10.3877/cma.j.issn.1674-6880.2021.05.007.
[9] Meybury J, Dill M, von Haken R,et al. Risk factors actors for the development of postoperative delirium in pediatric care patients[J]. Pediatr Crit Care Med,2018,19(10):e514-e521.DOI: 10.1097/PCC.0000000000001681.
[10] Hoch K. Current evidence-based practice for pediatricemergence agitation[J]. AANA J,2019,87(6):495-499.PMID:31920204.
[11] Silver G,Traube C,Gerber LM,et al.Pediatric delirium and associated risk factors:a single-center prospective observational study[J]. Pediatr Crit Care Med,2015,16(4):303-309. DOI:10.1097/PCC.0000000000000356.
[12] Meybury J,Dill M, Traube C, et al.Patterns of postoperative delirium in children[J]. Pediatr Crit Care Med,2017,18(2),128-133,2017.DOI:10.1097/PCC.0000000000000993.
[13] Patel AK,Biagas KV, Clarke EC,et al.Delirium in children after cardiac bypass surgery[J].Pediatr Crit Care Med, 2017, 18(2):165-171. DOI:10.1097/PCC.0000000000001032.
[14] Traube C, Silver G,Gerber LM,et al.Delirium and mortality in critically ill children:epidemiology and outcomes of pediatric delirium[J].Crit Care Med,2017,45(5):891-898.DOI:10.1097/CCM.0000000000002324.
[15] Urits I, Peck J, Giacomazzi S,et al.Emergence delirium in perioperative pediatric care:a review of current evidence and new directions[J]. Adv Ther,2020,37(5):1897-1909.DOI: 10.1007/s12325-020-01317-x.
[16] Ricardo RC, Alvaez GM,Agudelovelez CA, et al.Clinical characteristics, prevalence, and factors related to delirium in children of 5 to 14 years of age admitted to intensive care[J].Med Intensiva(Engl Ed),2019,43(3),147-155.DOI:10.1016/j.medine.2019.02.004.
[17] Malas N, Brathmbhatt K, Mcdermott C, et al.Pediatric delirium: evaluation, management, and special considerationas[J]. Curr Psychiatry Rep, 2017, 19(9):65. DOI:10.1007/s11920-017-0817-3.
[18] Norman S, Taha AA,Turner HN.Delirium in the critically ill child[J].Clin Nurse Spec,2017,31(5):276-284. DOI: 10.1097/NUR.0000000000000324.
[19] Moore AD, Anghelescu DL.Emergence delirium in pediatric anesthesia[J]. Pediatr Drugs,2017,19(1):11-20.DOI: 10.1007/s40272-016-0201-5.
[20] 彭晓静,刘海,张辉,等.右美托咪定对小儿术前焦虑和苏醒期谵妄的影响[J].上海医学, 2014, 37(12):2.
[21] Ovchinsky N, Frazier W, Auletta J,et al.Consensus report by the pediatric blood and marrow transplantation consortium joint working committees on supportive care guidelines for management of veno-occlusive disease in children and adolescents,part 3:focus on cardiorespiratory dysfunction,infections,liver dysfunction,and delirium[J].Biol Blood Marrow Transplant,2018, 24(2):207-218.DOI:10.1016/j.bbmt.2017.08.035.
[22] 刘柯显,冯静怡,徐红贞,等.儿童耳鼻喉术后谵妄发生现状及影响因素分析[J].中华急危重症护理杂志, 2021,2(1):70-74. DOI:10.3761/j.issn.2096-7446.2021.01.012.
[23] Rudolph JL, Inouye SK, Jones RN, et al.Delirium: an independent predictor of functional decline after cardiac surgery[J]. J Am Geriatr Society,2010,58(4):643-649.DOI:10.1111/j.1532-5415.2010.02762.x
[24] 刘书婷,王寿勇.小儿全身麻醉苏醒期谵妄的研究进展[J].重庆医学,2015,44(35):5035-5037. DOI: 10.3969/j.issn.1671-8348.2015.35.048.
[25] Joo J,Lee S,Lee Y.Emergence delirium is related to the invasiveness of strabismus surgery in preschool-age children[J].J Int Med Res, 2014, 42(6):1311-1322.DOI:10.1177/0300060514549783.
[26] Zou Y, Liu SH, Xue FS.Emergence agitation or delirium in children[J].J Anesth, 2022,36(1):156.DOI:10.1007/s00540-020-02785-9.
[27] Mohkamkar M, Farhoudi F, Alam-Sahebpour A, et al.Postanesthetic emergence agitation in pediatric patients under general anesthesia[J]. Iran J Pediatr,2014,24(2):184-190.
[28] 吕娟,贾艳.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, 3(24):232-239. DOI:10.7499/j.issn.1008-8830.2110026.
[29] Alvarez RV,Palmer C,Czaja AS,et al.Delirium is a common and early finding in patients in the pediatric cardiac intersive care unit[J]. J Pediatr, 2018,195:206-212. DOI:10.1016/j.jpeds.2017.11.064.
[30] 倪如飞,刘吉平,黄海文,等.右美托咪定预防儿童全麻苏醒期躁动和谵妄的安全有效剂量[J].广东医学,2017,38(11):1750-1753.
[31] Chandler JR, Myers D, Mehta D, et al.Emergence delirium in children:a randomized trial to compare total intravenous anesthesia with propofol and remifentanil to inhalational sevoflurane anesthesia[J]. Paediatr Anaesth, 2013,23(4):309-315 DOI:10.1111/pan.12090.
[32] 于洪丽,喻文立.全凭静脉麻醉对胆道闭锁患儿活体肝移植术后谵妄发生的影响[J].江苏医药, 2021,47(1):14-16. DOI:10.19460/j.cnki.0253-3685.2021.01.004.
[33] Oh AY, Seo KS, Kim SD, et al.Delayed emergence process does not result in a lower of emergence agitation after sevoflurane anesthesia in children[J].Acta Anesthesiol Scand,2005,49(3):297-299. DOI: 10.1111/j.1399-6576.2005.00687.x.
[34] Sinha A, Sood J.Caudal block and emergence delirium in pediatric patients: is it analgesia or sedation[J]. Saudi J Anesth,2012,6(4):403.DOI: 10.4103/1658-354X.105887.
[35] Wang H, Liu G, Fu W, et al.The effect of infraorbital nerve block on emergence ana agitation in children undergoing cldft lip surgery under general anesthesia with sevoflurane[J]. Pediatr Anesth, 2012, 22(11):1105-1109. DOI:10.1111/pan.12674.
[36] Turkel SB.Pediatric delirium: recognition, management, and outcome[J]. Curr Psychiatry Rep, 2017,19(12):101. DOI:10.1007/s11920-017-0851-1.
[37] Dervan LA, Di Gennaro JL, Farris RWD, et al.Delirium in a tertiary PICU: risk factors and outcomes[J]. Pediatr Crit Care Med,2020,21(1):21-32.DOI:10.1097/PCC.0000000000002126.
[38] 罗爱林,张杰.2017版欧洲麻醉学会《基于循证和专家共识的术后谵妄指南》解读[J].临床外科杂志2018,26(1):29-33. DOI:10.3969/j.issn.1005-6483.2018.01.009.
[39] Nellis ME, Goel R, Feinstein S, et al.Association between transfusion of RBCs and subsequent development of delirium in critically ill children[J].Pediatr Crit Care Med,2018,19(10):925-929. DOI: 10.1097/PCC.0000000000001675.

相关文章 15

[1]	曹娟, 李方, 于跃, 戴丽, 杨丹丹, 李志华, 徐欣怡, 戴琪, 陈柯宇. 食管癌术后静脉血栓栓塞症风险预测模型的构建及验证[J]. 护理学报, 2024, 31(8): 63-68.
[2]	朱心悦, 嵇冰聪, 蓝雪芬, 季晓珍. 糖尿病患者电子健康素养研究进展[J]. 护理学报, 2024, 31(7): 36-39.
[3]	李莹, 周志欢. ICU护理缺失的研究进展[J]. 护理学报, 2024, 31(6): 43-46.
[4]	黄鑫, 余丽君, 张二明, 哈丽娜. 稳定期COPD患者的能量摄入现状及影响因素分析[J]. 护理学报, 2024, 31(5): 12-16.
[5]	张可, 欧阳丽, 吴成慧, 廖秋燕, 谭玲玲, 朱维晔. 特定型语言障碍儿童语言发育水平的影响因素及路径分析[J]. 护理学报, 2024, 31(4): 7-11.
[6]	张思爱, 赖翠薇, 李佳佳, 张亚军, 汪张毅, 张正涛, 法天锷. 护士专业态度的影响因素研究进展[J]. 护理学报, 2024, 31(4): 38-41.
[7]	胡宁宁, 李玉凤, 王仁媛, 李婉君, 林素兰. 学龄前儿童超重肥胖现状及影响因素分析[J]. 护理学报, 2024, 31(2): 16-21.
[8]	姜妍, 黎佩莺, 王芳, 葛莉丽, 王桂梅, 田晓岚, 尹小兵. 临床护理软技能培训的影响因素及现状研究[J]. 护理学报, 2024, 31(2): 48-52.
[9]	胡玉兰, 陈英, 余艮珍, 王梦月. 儿科护士的慢性病患儿过渡期护理态度问卷编制及信效度检验[J]. 护理学报, 2024, 31(10): 64-69.
[10]	高若男, 王翠玲, 李亭雨, 田美雨, 张楠, 郑锐. 基于Pender健康促进模式食管癌术后患者饮食管理方案的构建[J]. 护理学报, 2024, 31(1): 12-16.
[11]	宋思梦, 李杨, 初丽丽, 王辉, 杨科力, 田晓迎. 高流量造口患者营养管理策略的研究进展[J]. 护理学报, 2024, 31(1): 42-45.
[12]	孙小卫, 王燕, 闵春燕, 段菲, 肖江琴. 322例老年COPD患者生活空间现状及影响因素分析[J]. 护理学报, 2023, 30(8): 1-6.
[13]	潘姝丞, 卞丽芳, 骆华芳, 黄旭叶, 黄昉芳, 曾颖, 王薇. 护士深静脉血栓形成风险知识与预防实践现状及影响因素分析[J]. 护理学报, 2023, 30(8): 7-11.
[14]	任影, 于卫华, 张利, 郑俊俊, 邓曼, 杨侠, 张雨溪. 社区老年人生活空间水平现状及影响因素分析[J]. 护理学报, 2023, 30(7): 11-15.
[15]	郑静, 管玉香, 张瑛, 许娟, 邹冉, 王超. 安徽省873名中医院护士长变革型领导力影响因素分析[J]. 护理学报, 2023, 30(7): 16-19.

Metrics

Viewed

Full text

Abstract

Cited

Shared