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作 者:聂琴琪[1] 张冰冰 王婉洁[1] NIE Qin-qi;ZHANG Bing-bing;WANG Wan-jie(Department of Critical Care Medicine, Shenzhen Hospital of Traditional Chinese Medicine, Shenzhen 518033, Guangdong, CHINA)
机构地区:[1]深圳市中医院重症医学科
出 处:《海南医学》2019年第12期1519-1521,共3页Hainan Medical Journal
摘 要:目的探讨危重症患者获得性衰弱的相关因素及其对患者预后、生活质量的影响。方法回顾性分析2017年1月至2018年5月期间深圳市中医院ICU收治的142例接受机械通气治疗的危重症患者的临床资料,将合并ICU获得性衰弱(ICU-AW)的64例患者纳入ICU-AW组,余78例患者纳入非ICU-AW组,比较两组患者的临床资料以及28 d死亡率,随访6个月时的死亡率及SF-36量表评分。结果ICU-AW组和非ICU-AW组患者的年龄[(61.6±6.4)岁vs(52.4±8.7)岁]、APACHEⅡ评分[(19.5±2.8)分vs(17.3±2.1)分]、空腹血糖[(9.2±2.6)mmol/L vs(7.1±2.3)mmol/L]、机械通气时间[(8.2±2.4)d vs(6.3±1.9)d]、ICU入住时间[(10.1±3.0)d vs(7.8±2.4)d]、合并脓毒症(52.94%vs 33.78%)及应用糖皮质激素的比例(41.18%vs 24.32%)比较,ICU-AW组均明显高于非ICU-AW组,差异均有统计学意义(P<0.05);ICU-AW组患者的28 d死亡率为26.47%,明显高于非ICU-AW组的13.51%,差异有统计学意义(P<0.05);随访6个月,ICU-AW组和非ICU-AW组患者的死亡率分别为8.00%、6.25%,差异无统计学意义(P>0.05);ICU-AW组患者SF-36评分为(63.5±7.0)分,明显低于非ICU-AW组的(78.9±8.2)分,差异有统计学意义(P<0.05)。结论获得性衰弱是ICU危重症患者的常见并发症,可影响患者的预后及生活质量。其中,年龄、APACHEⅡ评分、空腹血糖、机械通气时间、ICU入住时间,合并脓毒症及应用糖皮质激素是ICU-AW的影响因素。Objective To explore the related factors of acquired weakness in critically ill patients and its influence on prognosis and quality of life. Methods The clinical data of 142 critically ill patients treated with mechanical ventilation in ICU of Shenzhen Hospital of Traditional Chinese Medicine from January 2017 to May 2018 were selected and retrospectively analyzed, of which 64 patients with acquired weakness of ICU(ICU-AW) were enrolled into ICU-AW group, and 78 patients into non-ICU-AW group. The clinical data and 28-day mortality rates of the two groups were compared, and the mortality rates and SF-36 scale scores at 6 months of follow-up were compared. Results ICU-AW group were significantly higher in the following indexes than non-ICU-AW group(P<0.05): age,(61.6 ± 6.4) years vs(52.4±8.7) years;APACHE Ⅱ score,(19.5±2.8) vs(17.3±2.1);fasting blood glucose,(9.2±2.6) mmol/L vs(7.1±2.3) mmol/L;mechanical ventilation time,(8.2±2.4) d vs(6.3±1.9) d;ICU stay time,(10.1±3.0) d vs(7.8±2.4) d;proportion of sepsis,52.94% vs 33.78%;glucocorticoid use rate, 41.18% vs 24.32%. The 28-day mortality rate in ICU-AW group was 26.47%, significantly higher than 13.51% in non-ICU-AW group. There was no significant difference in mortality between the two groups(8.00% vs 6.25%) after 6 months of follow-up(P>0.05). The SF-36 score of ICU-AW group was 63.5±7.0, which was significantly lower than 78.9±8.2 of non-ICU-AW group(P<0.05). Conclusion Acquired weakness is a common complication of ICU critical patients, which can affect the prognosis and quality of life of patients.Age, APACHE Ⅱ score, fasting blood sugar, mechanical ventilation time, ICU stay time, sepsis, and glucocorticoid use were the influencing factors of ICU-AW.
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