重症脓毒症远期生活质量调查  

Survey of long-term quality of life in patients with severe sepsis

作　　者：程宝莉[1] 金悦[1] 刘喜旺[2] 章迎春[3] 陈香萍[4] 陈乐辉[5] 朱涛[4] 方向明[1] 

机构地区：[1]浙江大学医学院附属第一医院城站院区麻醉科,杭州310000 [2]浙江大学医学院附属儿童医院心胸外科,杭州310000 [3]浙江大学医学院附属邵逸夫医院精神科,杭州310000 [4]浙江大学医学院附属邵逸夫医院ICU,杭州310000 [5]浙江大学医学院附属邵逸夫医院神经科,杭州310000

出　　处：《解放军医学杂志》2011年第1期11-13,共3页Medical Journal of Chinese People's Liberation Army

基　　金：国家杰出青年科学基金(30825037)

摘　　要：目的分析重症脓毒症患者出院2年到5年以后的生活质量,为脓毒症的治疗和康复提供参考。方法采用前瞻性、观察性、双盲方法,随访2002年1月1日-2007年3月1日出院的重症脓毒症与非脓毒症外科危重病患者,根据纳入及排除标准,共362例进入随访计划,排除死亡、失访及拒绝的病例,最终51例纳入随访分析,采用SF-36量表对其生活质量进行评估。结果 51例患者年龄为52.3±19.1岁,其中男39例(76.5%),女12例(23.5%),随访时间3.41±1.24年(1245.3±450.3d),重症脓毒症(27例)与非脓毒症危重病(24例)患者的基本人口学资料、疾病严重程度评分和随访时间均无显著性差异,但重症脓毒症患者住院时间(60.2±47.4d)、住ICU时间(13.3±10.6d)、机械通气率(74.0%)及精神科药物应用(33.3%)均高于非脓毒症危重病患者(分别为27.3±12.6d、4.8±2.1d、45.8%、8.3%,P<0.05或P<0.01);重症脓毒症患者(27例)SF-36量表8个维度的得分较非脓毒症危重病患者(24例)偏低,但差异均无统计学意义(P>0.05)。结论重症脓毒症患者出院后远期生活质量与非脓毒症危重病患者无显著差异。Objective To evaluate the long-term quality of life of patients with severe sepsis after being discharged from hospital for 2 to 5 years.Methods Prospective cohort study and follow-up was conducted in 3 affiliated hospitals of Zhejiang University.Three hundred and sixty two severe sepsis and non-sepsis critical ill patients discharged from intensive care units of the participating hospitals during Jan.1st,2002 to Mar.1st,2007 were enrolled in present study.Fifty one cases were followed up,to the exclusion of those dead,loss to follow-up,refused to consent,younger than 18 years and the duration of stay in ICU was only or less than 1 day.Short form-36 scale（SF-36） was using to evaluate the quality of life of the 51 patients.Results The mean age of the 51 patients was 52.25±19.08 years,of whom 39（76.5%） were males and 12（23.5%） were females.The mean follow-up time was 3.41±1.24 years（1245.3±450.3 days）.No significant difference existed in age,gender,severity of disease and mean follow-up time between the patients survived from severe sepsis（n=27） and other critical ill as control group（n=24）.However,the length of stay in hospital,time in ICU,the ratio of mechanical ventilation and psychopharmacology therapy and mechanical ventilation（60.2±47.4 days,13.3±10.6 days,74.0%,33.3%,respectively） were higher in the patients survived from severe sepsis compared with those survived from non-sepsis（27.3±12.6 days,4.8±2.1 days,45.8%,8.3%,respectively,P〈0.05 or P〈0.01）.The median scores of eight domains in SF-36 were lower in severe sepsis patients compared with those in other critical ill patients,but there was no statistic difference.Conclusion No significant difference has been found by a 5 years follow-up in the long-term quality of life between the patients with severe sepsis and with non-sepsis critical ill.

关 键 词：脓毒症 长期预后 生活质量 

分 类 号：R631[医药卫生—外科学]