收稿日期: 2024-08-06
网络出版日期: 2025-04-02
Assessment and influencing factors of subsyndromal delirium in ICU：a scoping review
目的 对国内外关于ICU患者亚谵妄综合征的发生情况展开范围综述，系统性地整理并阐述该综合征的相关概念、评估手段以及影响因素，为ICU护理人员实施有效干预提供参考，以期减少亚谵妄综合征的发生率及其不良影响。方法 遵循Arksey和O’Malley所确立的系统性文献回顾框架，检索PubMed、Web of Science、Embase、CINAHL、Cochrane Library、中国知网、万方数据库、维普数据库、中国生物医学文献数据库以及指南网，检索时限为建库至2024年5月5日。结果 共纳入27篇文献，以前瞻性队列研究为主，共纳入3种评估工具，包括ICU患者意识模糊评估法、重症监护谵妄筛查量表和谵妄评定量表-98修订版。ICU患者亚谵妄综合征发生率较高，其主要影响因素包括患者年龄、性别、急性生理与慢性健康状况评分、手术、药物、环境等。结论 医护人员应提高对亚谵妄综合征的重视，加强对其影响因素的识别筛查，防止其进展成谵妄，提升护理质量，促进患者早期康复。
王梦倩 , 刘秀梅 , 康艳楠 , 唐妍 , 丛珊珊 , 贾云艳 . ICU亚谵妄综合征评估及影响因素的范围综述[J]. 中华急危重症护理杂志, 2025 , 6(4) : 499 -505 . DOI: 10.3761/j.issn.2096-7446.2025.04.021
Objective To conduct a scoping review of the status on subsyndromal delirium in ICU patients at home and abroad，systematically elaborate the related concepts，assessment methods and influencing factors of this syndrome，and provide reference for ICU nursing staff to implement effective interventions，in order to reduce the incidence and adverse effects of subsyndromal delirium. Methods This study followed the framework of systematic literature review established by Arksey and O’Malley，the literature search was performed in PubMed，Web of Science，Embase，CINAHL，Cochrane Library，CNKI，Wanfang Database，VIP Database，China Biomedical Literature Database，and guideline network，with a time limit from database establishment to May 5，2024. Results A total of 27 articles were included，most were prospective studies. Three assessment tools were included，the Confusion Assessment Method of Intensive Care Unit（CAM-ICU），Intensive Care Delirium Screening Checklist（ICDSC） and Delirium Rating Scale（DRS-R98）. Higher incidence of subsyndromal delirium was observed in ICU patients. The main influencing factors included age，gender，APACHE II score，surgery，medication，environment，etc. Conclusion Medical staff should pay more attention to subsyndromal delirium，strengthen the identification and screening of its influencing factors，prevent it from progressing，so as to improve the quality of nursing and promote the early rehabilitation of patients.
Key words： Intensive Care; ICU; Subsyndromal Delirium; Scoping Review; Nursing Care
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