ICU获得性衰弱对重症患者近远期预后的影响

The effect of ICU-acquired weakness on short-term and long-term prognosis of critically ill patients

目的探讨ICU获得性衰弱(ICU-AW)对重症患者死亡率和存活者生理功能的影响。方法选取2015年10月-2016年3月入住我院重症医学科并符合条件的256例患者为研究对象,根据有无ICU-AW分为ICUAW组和非ICU-AW组。记录参与者近期死亡例数,包括ICU期间和转至普通病房期间的死亡。出院后随访6个月,记录参与者的远期死亡情况,并对幸存者应用SF-36健康调查量表进行生理功能(PF)评估。结果与非ICUAW组相比,ICU-AW组的年龄较大,APACHE II评分较高,感染性疾病较多,机械通气时间和ICU入住时间较长。ICU-AW组近期死亡率显著高于非ICU-AW组(P<0.05),而远期死亡率差异无统计学意义(P>0.05)。结论ICU获得性衰弱对重症患者的近远期预后均有不良影响,需要积极地采取措施进行ICU-AW的预防和治疗。

Objective To explore the effect of ICU-AW on the mortality of critically ill patients and the physiological function of survivors.Methods 256 ICU subjects meeting the criteria were included between 2015.10.1 and2016.3.31 and were divided into the ICU-AW group and the non-ICU-AW group based on presence of ICU-AW.The number of recent deaths of participants,including death during ICU hospitalization and general ward hospitalization,were record.Patients were followed up for 6 months to record the long-term death of the participants,and the physiological function(PF)was assessed using the Mos 36-item Short Form Health Survey in survivors.Results Compared with non-ICU-AW group,ICU-AW group was older and had higher APACHE II score,more infectious diseases and longer mechanical ventilation time and ICU admission time.The short-term mortality of ICU-AW group was significantly higher than that of non-ICU-AW group,while long-term mortality rate didn't show significant difference between the 2 groups.The PF scores of ICU-AW group were significantly lower than that of non-ICUAW group at 6 months after discharge.Conclusions ICU-acquired weakness has an adverse impact on the short-term and long-term prognosis of critically ill patients and active measures are required to prevent and treat ICU-AW.