慢性阻塞性肺疾病急性加重患者发生ICU后综合征的危险因素分析  

Risk factors of post-ICU syndrome in patients with acute exacerbation of chronic obstructive pulmonary disease

作　　者：蒲桂梅 秦娥[1] 沈巨信[1] 孙健[1] 顾烁佳 PU Guimei;QIN E;SHEN Juxin;SUN Jian;GU Shuojia(Department of Respiratory Medicine,Shaoxing People's Hospital,Shaoxing 312000,China)

机构地区：[1]绍兴市人民医院呼吸内科,312000

出　　处：《浙江医学》2023年第7期744-747,共4页Zhejiang Medical Journal

摘　　要：目的探讨慢性阻塞性肺疾病急性加重(AECOPD)患者经ICU综合治疗后发生ICU后综合征(PICS)的危险因素。方法选取2018年5月至2022年11月绍兴市人民医院由ICU转入呼吸科普通病房的70例AECOPD患者为研究对象,根据有无出现PICS,将患者分为PICS组27例和无PICS组43例。比较两组患者的基本情况、不良生活习惯、在ICU期间治疗情况及实验室检查结果。二元logistic回归分析AECOPD患者发生PICS的危险因素。结果单因素分析显示,两组患者年龄、文化程度、机械通气时间≥7 d情况、血管活性药物、喹诺酮类药物使用情况、氧合指数比较,差异均有统计学意义(均P<0.05)。多因素分析显示,年龄大、机械通气时间≥7 d、使用喹诺酮类药物、氧合指数下降均是AECOPD患者发生PICS的危险因素(均P<0.05)。结论临床上应对年龄大、机械通气时间长、使用喹诺酮类药物、氧合指数下降的AECOPD患者发生PICS的可能提高警惕,并采取干预措施,从而预防或减少PICS的发生。Objective To explore risk factors of post-ICU syndrome(PICS)in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods From May 2018 to November 2022,70 patients with AECOPD admitted in intensive care unit(ICU)in Shaoxing People's Hospital,PICS developed in 27 cases(PICS group)after transferred to the general ward of the respiratory medicine department,and PICS did not develop in the remaining 43 cases(non-PICS group).The general information,life style,ICU treatment and laboratory tests were compared between two groups;risk factors for developing PICS were analyzed with univariate and multivariate logistic regression.Results Univariate analysis showed that the age,educational level,duration of mechanical ventilation≥7 d,use of vasoactive drugs and quinolone,and oxygenation index level were significantly associated with the development of PICS(all P<0.05).Multivariate logistic regression analysis showed that older age,duration of mechanical ventilation≥7 d,quinolone use and decreased oxygenation index were independent risk factors for PICS in AECOPD patients(all P<0.05).Conclusion To prevent or reduce the occurrence of PICS,in ICU care more attention should be paid for AECOPD patients with older age,long mechanical ventilation duration,quinolones use and decreased oxygenation index.

关 键 词：慢性阻塞性肺疾病急性加重 ICU后综合征 危险因素 

分 类 号：R563.9[医药卫生—呼吸系统]