重症患者低活动型谵妄研究的范围综述

doi:10.3761/j.issn.2096-7446.2025.04.022

摘要/Abstract

摘要：

目的对国内外重症患者低活动型谵妄的相关研究进行范围综述，梳理低活动型谵妄的现状、危险因素、评估工具、评估时机和干预方法等，为预防和管理重症患者低活动型谵妄提供科学依据。方法基于范围综述框架，系统检索PubMed、Cochrane Library、CINAHL、Web of Science、中国知网、万方数据库、中国生物医学文献数据库和维普数据库中有关重症患者低活动型谵妄的相关研究，检索时限为建库至2024年12月23日。由2名研究者对纳入的文献进行数据提取及汇总分析。结果最终纳入21篇文献。重症患者低活动型谵妄的发生率为6.60%~92.00%。主要应用ICU意识模糊评估法和Richmond躁动-镇静量表2种评估工具，多数研究每日评估1~2次，评估时间集中在08：00—09：00左右和18：00左右。重症患者低活动型谵妄的影响因素包括高龄、糖尿病、饮酒史、急诊手术、约束带的使用等。干预措施为实施早期综合护理干预。结论低活动型谵妄在重症患者中发生率较高且具有严重的不良影响，影响因素复杂多样，评估和诊断工具种类较少且缺乏特异性，评估时机和频率尚不统一，干预研究较少且设计单一。建议医护人员从评估诊断工具、时机和干预方法等方面加深研究，为低活动型谵妄的预防和管理提供科学依据。

关键词: 重症监护病房, 危重症患者, 低活动型谵妄, 范围综述, 循证护理学

Abstract:

Objective To conduct a scoping review of relevant studies on hypoactive delirium in critically ill patients at home and abroad， to sort out the current status of hypoactive delirium， risk factors， assessment tools， timing of assessment， and intervention methods， etc.， so as to provide scientific basis for the prevention and management of hypoactive delirium in critically ill patients. Methods Based on the scoping review framework，a systematic search was conducted for relevant studies on hypoactive delirium in critically ill patients in Pubmed， the Cochrane Library，CINAHL，Web of Science，China Knowledge Network，Wanfang Database，China Biomedical Literature Database，and VIP database，with a timeframe of the construction of the database to December 2024. Data extraction and summary analysis of the included literature were performed by two researchers. Results 21 papers were eventually included. The prevalence of hypoactive delirium in critically ill patients ranged from 6.60% to 92.00%. Two assessment tools， ICU Ambiguity of Consciousness Assessment Method and Richmond Agitation-Sedation Scale，were mainly applied， and most of the studies assessed once a day，focusing on around 8:00-9:00 and 18:00. Factors influencing hypoactive delirium in critically ill patients included advanced age， diabetes，history of alcohol consumption， emergency surgery， and restraint use. Early integrated nursing interventions for patients were implemented. Conclusion Hypoactive delirium has a high incidence and serious adverse effects in critically ill patients，with complex and varied influencing factors， fewer types of assessment and diagnostic tools and lack of specificity，inconsistencies in the timing and frequency of assessment，and fewer intervention studies and a single design. It is recommended that healthcare professionals should deepen their research on assessment and diagnostic tools，assessment timing and intervention methods to provide a scientific basis for the prevention and management of hypoactive delirium.

Key words: ICU, Critical Patients, Hypoactive Delirium, Scoping Review, Evidence-Based Nursing

王立庆, 罗洁玲, 商博坤, 马桂云. 重症患者低活动型谵妄研究的范围综述[J]. 中华急危重症护理杂志, 2025, 6(4): 506-512.

WANG Liqing, LUO Jieling, SHANG Bokun, MA Guiyun. Study of hypoactive delirium in critically ill patients: a scoping review[J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(4): 506-512.

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