Ringdal Mona, Johansson Lotta, Lundberg Dag, Bergbom Ingegerd
Institute of Health and Care Sciences, The Sahlgrenska Academy at Göteborg University, Box 457, SE-40530 Göteborg, Sweden.
Intensive Crit Care Nurs. 2006 Dec;22(6):346-54. doi: 10.1016/j.iccn.2006.03.001. Epub 2006 Aug 9.
During and after intensive care unit (ICU) stays some patients report unreal experiences or so called delusional memories, which can be a source of distress. The aims of this study were: to describe trauma patients' memories of their stay in the ICU, factors that may influence delusional memories, problems experienced after discharge from the ICU and the patients' return to work. In this multi-centre study, 239 trauma patients filled in a self-administered questionnaire (ICUM tool) 6-18 months after their ICU stay. Clinical data were obtained from patient records. Fifteen percent of the respondents had no memory whatsoever of the ICU. Factual memories such as visits by family members were recalled by 83%. Delusional memories were reported by 26%, nightmares being the most common. These patients' also had more memories of pain, fear and panic. Significant factors associated with delusional memories were age <50 year, ICU stay >or=3 days, temperature >or=38 degrees C, S-Haemaglobin <or=100g/l, renal failure, surgery, ventilator support, sedative drugs, and opioids. A logistic regression analysis of all significant factors revealed that age was the best predictor of delusional memories. Significantly more patients with delusional memories reported unexplained feelings of panic after discharge from the ICU and had still not returned to work 1 year after the trauma. In conclusion, patients with delusional memories are younger and these memories affect them even after discharge from the ICU.
在重症监护病房（ICU）住院期间及之后，一些患者会报告不真实的经历或所谓的妄想性记忆，这可能会成为困扰的来源。本研究的目的是：描述创伤患者对其在ICU住院期间的记忆、可能影响妄想性记忆的因素、从ICU出院后所经历的问题以及患者恢复工作的情况。在这项多中心研究中，239名创伤患者在其ICU住院6至18个月后填写了一份自填式问卷（ICUM工具）。临床数据从患者记录中获取。15%的受访者对ICU毫无记忆。83%的患者回忆起了诸如家人探访等事实性记忆。26%的患者报告有妄想性记忆，其中噩梦最为常见。这些患者对疼痛、恐惧和恐慌也有更多记忆。与妄想性记忆相关的显著因素包括年龄<50岁、ICU住院时间≥3天、体温≥38摄氏度、血清血红蛋白≤100g/l、肾衰竭、手术、呼吸机支持、镇静药物和阿片类药物。对所有显著因素进行逻辑回归分析显示，年龄是妄想性记忆的最佳预测指标。有妄想性记忆的患者在从ICU出院后报告有不明原因恐慌情绪的比例显著更高，并且在创伤发生1年后仍未恢复工作。总之，有妄想性记忆的患者更年轻，而且这些记忆即使在他们从ICU出院后仍会对其产生影响。
