ABSTRACT
Objective To investigate the influential factors and nursing measures for mental disorders after liver transplantation. Methods Seventy-two patients had undergone liver transplantation and thirty-eight of them affected mental disorders and 34 of them did not. The mental disorder group and the non-mental disorder group were compared in terms of sex, age, mechanical ventilation time, pressure percentage mean of arterial pressure, intraoperative blood loss, duration of operation time, ICU stay time, postoperative pain duration and degree, Bullock complex (tacrolimus, FK506) blood drug concentration, history of preoperative hepatic encephalopathy, postoperative use of sedatives, postoperative constraint, postoperative metabolic abnormalities and disorders and infection. The plain logistic regression analysis was used to abstract the risk factors for mental disorders. Results The independent influential factors for the complicated mental disorders included the mean arterial pressure lower than that of pressure percentage> 20%, postoperative pain duration > 5 h and score by the numerical rating scale ( NRS ) > 4 , FK506 blood drug concentration> 13 ng/mL, postoperative abnormality, disturbance of metabolism and infection (P < 0.01). Conclusion The incidence rate of postoperative mental disorders is high among the patients having undergone liver transplantation. The influential factors for the mental disorder include blood pressure and postoperative pain duration and degree , FK506 blood drug concentration and metabolic abnormalities and disorders, and infection. The nursing measures like family nursing, effective control of blood pressure, postoperative analgesia, monitoring the drug concentration, maintaining a stable environment and preventing infection after liver transplantation are critical for the reduced rate of mental disorder.
ABSTRACT
Objectives To explore the influencing factors of delirium in elderly patients with mechanical ventilation in ICU. Methods Using a self-designed questionnaire,the investigation was done among 210 patients undergoing mechanical ventilation to evaluate the delirium condition and look into the influence factors of delirium.Results 112 cases(53.3%)of the elderly patients were affected with delirium.The major influencing factors included duration of mechanical ventilation,acute physiology and chronic health evaluation(APACHEⅡ),hypoxia,sleep deprivation.Conclusion The incidence of delirium is higher among the elderly patients with mechanical ventilation.As for nursing strategy,providence of family nursing,close observation of the disease changes, enhanced respiratory function and practical orientation cognitive training are important for the reduction of the incidence of delirium in the elderly patients with mechanical ventilation.
