摘要目的：探讨重症医学科（ICU）患者精神障碍的相关危险因素与干预措施。方法收集2013年1月至2014年12月符合条件的入住 ICU 的568例患者，分析高血压史、酗酒史、手术史、机械通气、入 ICU 时间、护理质量、急性生理与慢性健康状况评分Ⅱ（APACHE Ⅱ评分）、电解质紊乱、射血分数、睡眠障碍、降钙素原、氧合指数、使用咪达唑仑、阿片类药物等与 ICU 精神障碍发生的关系。结果568例患者（男345例，女223例），发生精神障碍157例，总体临床发生率为27．6％；568例患者中男女性别之比为1．55：1，发生精神障碍（男96例，女61例）男女比为1．57：1，平均年龄（65．5±11．2）岁；未发生精神障碍（男249例，162例）男女比为1．30：1，平均年龄（48．8±14．3）岁；Logistic 回归分析示：高血压病史、酗酒史、手术史、机械通气、入ICU 时间、护理质量、APACH Ⅱ评分、电解质紊乱、射血分数、睡眠障碍、降钙素原、氧合指数、使用咪达唑仑、阿片类药物是 ICU 患者发生精神障碍的危险因素（均 P ＜0．05）。结论 ICU 住院患者有高血压史、酗酒史，应用机械通气，应该严密监测与评估，早期行精神障碍的筛查，及时采取相应的防治措施，高护理质量可以明显减少 ICU 患者精神障碍的发生率。

abstractsObjective To investigate the risk factors of mental disorders of patients treated in intensive care unit(ICU).Methods Collected from January 2013 to December 2014 ICU stay eligible cases,and analyzed the past history (hypertension,intemperance),previous surgery,mechanical ventilation,date of ICU admission,quality of care, APACHE II score,electrolyte disorder,LVEF,sleep disturbance,PCT,oxygenation index,drug use situation (midazo-lam,opioids)and the clinical care unit the incidence of mental disorders in relationship.Results 568 patients (male 345 cases,female 223 cases),mental disorders group of 157 patients,the clinical incidence rate of 27.6% overall;568 patients were in the sex ratio of 1.55:1,mental disorders group of 157 patients(96 males,61 females),male to female ratio 1.57:1,mean age was (65.5 ±11.2)years;no mental disorders group (249 males,162 females),male to female ratio 1.30:1,mean age was (48.8 ±14.3)years.Logistic regression analysis revealed that coronary heart disease,hypotension,alcohol abuse,surgery,mechanical ventilation,ICU admission time,quality of care,APACHE II score,electrolyte imbalance,ejection fraction,sleep disorders,procalcitonin,oxygenation index,use of midazolam or opioids were among the risk factors of ICU mental disorders.Mechanical ventilation,quality of care,hypotension,alco-hol abuse,and use of midazolam were independent risk factors for ICU mental disorders (all P <0.05).Conclusion ICU inpatients with past history of hypertension and intemperance,use of mechanical ventilation and midazolam should be closely monitored and evaluated,early psycho -psychiatric screening,and take effective measures in time;high -quality care can reduce the incidence of mental disorders in ICU patients significantly.