麻醉重症监护治疗病房患者疾病特征及预后分析  

Analysis of clinical characteristics and prognosis of patients in anesthesia intensive care unit

作　　者：王聪[1] 王照飞[1] 吕保峰 孙政[1] 方申 卢璐 王勇[1] Wang Cong;Wang Zhaofei;Lyu Baofeng;Sun Zheng;Fang Shen;Lu Lu;Wang Yong(Department of Anesthesia and Perioperative Medicine,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院麻醉与围术期医学部,郑州450052

出　　处：《国际麻醉学与复苏杂志》2023年第12期1295-1300,共6页International Journal of Anesthesiology and Resuscitation

摘　　要：目的 通过收集麻醉重症监护治疗病房(anesthesia intensive care unit,AICU)患者的临床资料,分析围手术期患者转入AICU 的原因和预后结局,为新建AICU提供参考.方法 回顾性分析郑州大学第一附属医院AICU 2019年4月1 日至2022年10月31 收治的4 810例患者的病例资料,统计患者的一般资料[年龄、性别、合并基础疾病种类、急性生理学与慢性健康状况评分系统Ⅱ(Acute Physiology and Chronic Health Evaluation Ⅱ,APACHE Ⅱ)评分]、转入AICU原因、手术类型、AICU治疗时间、预后结局(好转、转入其他ICU、自动出院、死亡)和转回普通病房48 h 内重返ICU(包括转回AICU和转入其他ICU)的原因.结果 AICU共收治4 810例患者,年龄(59±17)岁,男性3 085例,女性1725例,治疗时间1(1)d,94.9%(4 563/4810)患者好转后转回普通病房或治愈出院,0.9%(44/4 810)患者转入其他ICU,3.5%(170/4 810)患者自动出院,0.7%(33/4810)患者死亡.AICU收治的患者来源包括术后转入(87.2%)、普通病房转入(10.7%)和急诊入院(2.1%).术后转入患者4 197例,好转率为97.3%(4 085/4 197),AICU治疗时间为1(1)d,手术类型排在前6位的依次为眼耳鼻咽喉手术(18.5%)、普外腹腔手术(18.2%)、泌尿手术(14.0%)、骨科手术(13.0%)、胸外手术(11.0%)和口腔手术(8.6%).术后转入AICU原因主要为手术因素(29.6%)、气道问题(25.5%)和合并症多(24.1%).术后转入AICU的患者治疗好转后转回普通病房,48 h ICU重返率为1.6%(66/4 197),最常见的重返原因是出现呼吸系统并发症,重返ICU病死率为18.2%(12/66).普通病房转入患者513例,好转率为79.2%,AICU治疗时间2(4)d,主要转入AICU的原因为呼吸障碍(36.1%)、循环障碍(22.0%)和昏迷(20.3%).急诊入院患者100例,好转率72.0%,治疗时间6(9)d.结论 手术后患者是AICU收治患者的主要来源,治疗时间短,好转率高,AICU在围手术期患者救治过程中起到重要作用.Objective To collect the clinical data of patients in anesthesia intensive care unit(AICU),and analyze the reasons and prognosis of perioperative patient admission to AICU,in order to provide reference for establishment of new AICU.Methods A total of 4810 patients who were admitted to the AICU of the First Affiliated Hospital of Zhengzhou University from April 1,2019 to October 31,2022 were selected and their clinical data were retrospectively analyzed.Their general information[age,gender,basic disease types,Acute Physiology and Chronic Health EvaluationⅡ(APACHEⅡ)scores],the cause to transfer to AICU,surgery types,treatment duration of AICU,prognosis[including recovery,transferred to other intensive care unit(ICU),discharged automatically and died],and the reasons for readmission to the ICU(including AICU and other ICU)within 48 h were documented.Results A total of 4810 patients were admitted to AICU,with an average age of(59±17)years,including 3085 men and 1725 women.The median treatment duration was 1(1)d.Notably,94.9%(4563/4810)of patients returned to the general ward or were discharged after recovery,0.9%(44/4810)of patients were transferred to other ICU,3.5%(170/4810)were discharged automatically,and 0.7%(33/4810)of patients died.Patient admissions to AICU originated from three main sources:postoperative transfers(87.2%),ward transfers(10.7%),and emergency admissions(2.1%).Ager surgery,4197 patients were transferred to AICU,accounting for 87.2%of the total number.The treatment improvement rate was 97.3%(4085/4197)and a median treatment duration in AICU was 1(1)d.The top six surgical types for postoperative transfers were ophthalmic and otorhinolaryngologic surgery(18.5%),general abdominal surgery(18.2%),urological surgery(14.0%),orthopedic surgery(13.0%),thoracic surgery(11.0%),and oral surgery(8.6%).The primary reasons for postoperative transfers to AICU were surgical factors(29.6%),airway problems(25.5%),and medical complications(24.1%).Among postoperative patients,the readmission rate to the AICU wit

关 键 词：麻醉重症监护治疗病房 围手术期 危重症 预后 

分 类 号：R614[医药卫生—麻醉学]