目的 分析术前总胆红素（total bilirubin,TBIL）、血肌酐（serum creatinine,Scr）及国际标准化比值(international normalized ratio,INR)与肝移植患者术后谵妄（postoperative delirium,POD）的非线性关系。方法 采用便利抽样法选取北京市某三级甲等医院2019年1月至2024年4月收治的523例肝移植患者为研究对象，使用病例综述法评估POD。 结果 肝移植患者POD发生率为14.34%。术前 INR与POD之间存在非线性剂量反应关系(χ²=7.06，P=0.029)，术前总胆红素（total bilirubin,TBIL）和血肌酐（serum creatinine,Scr）与POD的关联无统计学意义（均P＞0.05）。结论 在肝移植患者中，将术前INR水平维持在1.43以下能降低肝移植POD发生风险。因此，护理人员应密切关注患者的术前INR水平，将其控制在安全界值范围内。

Objective To analyze the nonlinear relationships between preoperative total bilirubin（TBIL),serum creatinine（Scr),and international normalized ratio（INR) and postoperative delirium（POD) in liver transplant patients.Methods The convenience sampling method was used to select 523 liver transplant patients admitted to a tertiary A hospital in Beijing from January 2019 to April 2024 as study subjects.POD was assessed by the case review method.Results The incidence of POD in liver transplant patients was 14.34%.A nonlinear dose-response relationship was found between preoperative INR and POD（χ²=7.06，P=0.029),while no statistically significant associations were observed between preoperative TBIL and Scr and POD（all P＞0.05).Conclusions Maintaining preoperative INR levels below 1.43 can reduce the risk of POD occurrence among liver transplant patients.Therefore,caregivers should closely monitor preoperative INR levels and keep them within the safe threshold range.

R473.6

国家自然科学基金重点项目（62331016）