关键词: 肿瘤, 临终病人, 谵妄, 影响因素, 临终关怀医疗

Abstract:

Objective To investigate the current status of delirium of terminal cancer patients,and to explore the influencing factors and provide evidence for clinical early assessment and screening. Methods Data of terminal cancer patients were collected from a hospice care unit from October 2016 to March 2018. Logistic regression model was used to analyze the independent influencing factors of delirium in terminal cancer patients. Results This study included 231 patients with 139 cases of delirium,and the incidence of delirium was 60.2%. Score of Eastern Cooperative Oncology Group（ECOG）,Palliative Prognostic Index（PPI）,medicine type（opioids,benzodiazepines,corticosteroids）,polypharmacy（drug types≥3）,symptom（infection,sleep disorder,constipation,hypoxia,cachexia）,liver/kidney failure,electrolyte imbalance,brain metastasis,and immobilization were related to delirium（P<0.05）;Logistic regression model showed that using opioids（OR=1.477）,infection（OR=3.782）,sleep disturbance（OR=4.209）,and PPI（OR=6.285） were independent influencing factors of delirium. Conclusion The incidence of delirium of terminal cancer patients is still high. The use of opioids,infection,sleep disturbance,and PPI can cause delirium. Health staff should evaluate influencing factors early to decrease the incidence of delirium.

Key words: Neoplasms, Terminally Ill, Delirium, Influencing Factors, Hospice Care