• 文献检索
  • 文档翻译
  • 深度研究
  • 学术资讯
  • Suppr Zotero 插件Zotero 插件
  • 邀请有礼
  • 套餐&价格
  • 历史记录
应用&插件
Suppr Zotero 插件Zotero 插件浏览器插件Mac 客户端Windows 客户端微信小程序
定价
高级版会员购买积分包购买API积分包
服务
文献检索文档翻译深度研究API 文档MCP 服务
关于我们
关于 Suppr公司介绍联系我们用户协议隐私条款
关注我们

Suppr 超能文献

核心技术专利：CN118964589B侵权必究
粤ICP备2023148730 号-1Suppr @ 2026

文献检索

告别复杂PubMed语法，用中文像聊天一样搜索，搜遍4000万医学文献。AI智能推荐，让科研检索更轻松。

立即免费搜索

文件翻译

保留排版，准确专业，支持PDF/Word/PPT等文件格式，支持 12+语言互译。

免费翻译文档

深度研究

AI帮你快速写综述，25分钟生成高质量综述，智能提取关键信息，辅助科研写作。

立即免费体验

头颈部肿瘤重建手术后谵妄的危险因素：一项回顾性临床试验。

Risk Factors of Delirium Following Reconstructive Surgery for Head and Neck Tumors: A Retrospective Clinical Trial.

作者信息

Li Lulan, Zhang Liupan, Wu Xixuan, Zeng Zhenhua

机构信息

Department of Critical Care Medicine, Nanfang Hospital, The First School of Clinical Medicine, Southern Medical University, Guangzhou, People's Republic of China.

Department of Internal Medicine, Zhongshan Shenwan Hospital, Zhongshan, People's Republic of China.

出版信息

Ther Clin Risk Manag. 2025 Jan 24;21:81-91. doi: 10.2147/TCRM.S480272. eCollection 2025.

DOI:10.2147/TCRM.S480272
PMID:39876888
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11774114/
Abstract

BACKGROUND

Patients after head and neck tumor reconstruction surgery frequently require deep sedation and analgesia in the ICU. However, the risk factors for delirium associated with propofol-based sedation remain unclear.

OBJECTIVE

The study aimed to explore the risk factors of delirium of propofol singled or combined sedation.

METHODS

This retrospective study analyzed ICU patients who underwent head and neck tumor reconstruction surgery. The patients were divided into three groups: propofol (P), propofol + midazolam (PM), and propofol + dexmedetomidine (PD) groups. We utilized univariate and multivariate logistic regression to identify risk factors of delirium.

RESULTS

Delirium occurred in 4 (7.02%), 11 (28.21%), and 5 (20.83%) patients in the P, PM and PD groups, respectively. Elevated mean arterial pressure (MAP), increased aspartate aminotransferase (AST) levels, and the combined use of midazolam were determined to be significant risk factors for delirium in this patient cohort. The combined use of midazolam is the strongest predictor of delirium, which can increase the risk of delirium by 3.218 times (95% CI = 1.041-9.950, p = 0.042).

CONCLUSION

Propofol combined with midazolam for sedation in patients after head and neck tumor reconstruction surgery may increase the risk of delirium.

摘要

背景

头颈部肿瘤重建手术后的患者在重症监护病房（ICU）常常需要深度镇静和镇痛。然而，与丙泊酚镇静相关的谵妄危险因素仍不清楚。

目的

本研究旨在探讨丙泊酚单药或联合镇静时谵妄的危险因素。

方法

这项回顾性研究分析了接受头颈部肿瘤重建手术的ICU患者。患者被分为三组：丙泊酚组（P）、丙泊酚+咪达唑仑组（PM）和丙泊酚+右美托咪定组（PD）。我们采用单因素和多因素逻辑回归分析来确定谵妄的危险因素。

结果

P组、PM组和PD组谵妄发生例数分别为4例（7.02%）、11例（28.21%）和5例（20.83%）。平均动脉压（MAP）升高、天冬氨酸转氨酶（AST）水平升高以及咪达唑仑的联合使用被确定为该患者队列中谵妄的显著危险因素。咪达唑仑的联合使用是谵妄最强的预测因素，可使谵妄风险增加3.218倍（95%CI = 1.041 - 9.950，p = 0.042）。

结论

头颈部肿瘤重建手术后患者使用丙泊酚联合咪达唑仑进行镇静可能会增加谵妄风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3e5a/11774114/99f0fbad07fe/TCRM-21-81-g0004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3e5a/11774114/db35c4ad4e47/TCRM-21-81-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3e5a/11774114/c4395a1a9106/TCRM-21-81-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3e5a/11774114/cc07987b4f08/TCRM-21-81-g0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3e5a/11774114/99f0fbad07fe/TCRM-21-81-g0004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3e5a/11774114/db35c4ad4e47/TCRM-21-81-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3e5a/11774114/c4395a1a9106/TCRM-21-81-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3e5a/11774114/cc07987b4f08/TCRM-21-81-g0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3e5a/11774114/99f0fbad07fe/TCRM-21-81-g0004.jpg

相似文献

1
Risk Factors of Delirium Following Reconstructive Surgery for Head and Neck Tumors: A Retrospective Clinical Trial.头颈部肿瘤重建手术后谵妄的危险因素：一项回顾性临床试验。
Ther Clin Risk Manag. 2025 Jan 24;21:81-91. doi: 10.2147/TCRM.S480272. eCollection 2025.
2
The risk of delirium after sedation with propofol or midazolam in intensive care unit patients.重症监护病房患者使用丙泊酚或咪达唑仑镇静后发生谵妄的风险。
Br J Clin Pharmacol. 2024 Jun;90(6):1471-1479. doi: 10.1111/bcp.16031. Epub 2024 Mar 14.
3
Comparison between midazolam and propofol in acute phase for ventilated patients with sepsis: a analysis of the DESIRE trial.咪达唑仑与丙泊酚用于脓毒症机械通气患者急性期的比较：DESIRE试验分析
Acute Med Surg. 2022 Apr 5;9(1):e746. doi: 10.1002/ams2.746. eCollection 2022 Jan-Dec.
4
[Methohexital for analgosedation of ventilated intensive care patients : prospective nonrandomized single center observational study on incidence of delirium].[美索比妥用于机械通气重症监护患者的镇痛镇静：关于谵妄发生率的前瞻性非随机单中心观察性研究]
Anaesthesist. 2014 Jun;63(6):488-95. doi: 10.1007/s00101-014-2317-8. Epub 2014 May 14.
5
Sedation strategy and ICU delirium: a multicentre, population-based propensity score-matched cohort study.镇静策略与 ICU 谵妄：一项多中心、基于人群的倾向评分匹配队列研究。
BMJ Open. 2021 Jul 20;11(7):e045087. doi: 10.1136/bmjopen-2020-045087.
6
Dexmedetomidine versus propofol sedation in reducing delirium among older adults in the ICU: A systematic review and meta-analysis.右美托咪定与丙泊酚镇静对 ICU 老年患者谵妄发生率的影响：系统评价和荟萃分析。
Eur J Anaesthesiol. 2020 Feb;37(2):121-131. doi: 10.1097/EJA.0000000000001131.
7
[A study of using dexmedetomidine in ventilator bundle treatment in an ICU].[右美托咪定在重症监护病房呼吸机集束治疗中的应用研究]
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2015 Oct;27(10):836-40.
8
[The influence of the sedation based on remifentanil analgesia on the occurrence of delirium in critically ill patients].[瑞芬太尼镇痛镇静对危重症患者谵妄发生的影响]
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2015 Oct;27(10):845-9.
9
Pain, fentanyl consumption, and delirium in adolescents after scoliosis surgery: dexmedetomidine vs midazolam.青少年脊柱侧弯手术后的疼痛、芬太尼用量及谵妄：右美托咪定与咪达唑仑的比较
Paediatr Anaesth. 2013 May;23(5):446-52. doi: 10.1111/pan.12128. Epub 2013 Feb 28.
10
Comparison of dexmedetomidine versus propofol for sedation in mechanically ventilated patients after cardiovascular surgery.右美托咪定与丙泊酚用于心血管手术后机械通气患者镇静的比较。
Methodist Debakey Cardiovasc J. 2014 Apr-Jun;10(2):111-7. doi: 10.14797/mdcj-10-2-111.

本文引用的文献

1
Sequential use of midazolam and dexmedetomidine for long-term sedation may reduce weaning time in selected critically ill, mechanically ventilated patients: a randomized controlled study.序贯使用咪达唑仑和右美托咪定进行长期镇静可能会减少选定的危重症、机械通气患者的撤机时间：一项随机对照研究。
Crit Care. 2022 May 3;26(1):122. doi: 10.1186/s13054-022-03967-5.
2
Effect of midazolam on delirium in critically ill patients: a propensity score analysis.咪达唑仑对重症患者谵妄的影响：倾向评分分析。
J Int Med Res. 2022 Apr;50(4):3000605221088695. doi: 10.1177/03000605221088695.
3
Delirium in critical illness: clinical manifestations, outcomes, and management.
危重病患者谵妄：临床表现、结局和管理。
Intensive Care Med. 2021 Oct;47(10):1089-1103. doi: 10.1007/s00134-021-06503-1. Epub 2021 Aug 16.
4
Sedation strategy and ICU delirium: a multicentre, population-based propensity score-matched cohort study.镇静策略与 ICU 谵妄：一项多中心、基于人群的倾向评分匹配队列研究。
BMJ Open. 2021 Jul 20;11(7):e045087. doi: 10.1136/bmjopen-2020-045087.
5
Incidence and risk factors of delirium in surgical intensive care unit.外科重症监护病房谵妄的发病率及危险因素
Trauma Surg Acute Care Open. 2021 Mar 3;6(1):e000564. doi: 10.1136/tsaco-2020-000564. eCollection 2021.
6
Midazolam Premedication Immediately Before Surgery Is Not Associated With Early Postoperative Delirium.手术前即刻给予咪达唑仑镇静与术后早期谵妄无关。
Anesth Analg. 2021 Sep 1;133(3):765-771. doi: 10.1213/ANE.0000000000005482.
7
Comparison between Dexmedetomidine and Midazolam for Sedation in Patients with Intubation after Oral and Maxillofacial Surgery.口腔颌面手术后插管患者中右美托咪定与咪达唑仑镇静的比较。
Biomed Res Int. 2020 Apr 8;2020:7082597. doi: 10.1155/2020/7082597. eCollection 2020.
8
Postoperative delirium after reconstructive surgery for oral tumor: a retrospective clinical study.口腔肿瘤重建手术后的术后谵妄：一项回顾性临床研究。
Int J Oral Maxillofac Surg. 2020 Sep;49(9):1143-1148. doi: 10.1016/j.ijom.2020.01.018. Epub 2020 Feb 27.
9
Evolving targets for sedation during mechanical ventilation.机械通气镇静治疗的目标不断变化。
Curr Opin Crit Care. 2020 Feb;26(1):47-52. doi: 10.1097/MCC.0000000000000687.
10
New benzodiazepines for sedation.新型苯二氮䓬类镇静药物。
Best Pract Res Clin Anaesthesiol. 2018 Jun;32(2):149-164. doi: 10.1016/j.bpa.2018.06.007. Epub 2018 Jul 3.