ICU获得性衰弱的危险因素以及对患者近远期预后的影响

Short-and Long-term Effect of ICU-Acquired Weakness on the Prognosis of Critically Ill Patients

目的探讨ICU获得性衰弱(ICU-acquired weakness,ICU-AW)对重症患者病死率和远期生理功能的影响。方法便利抽样选择2014年12月至2016年5月之间入住江油市第二人民医院重症医学科并符合条件的276例患者为研究对象,根据有无ICU-AW分为ICU-AW组和非ICU-AW组。记录两组患者近远期死亡例数,并对幸存者应用SF-36健康调查量表进行生理功能评估。结果与非ICU-AW组相比,ICU-AW组的年龄较大,急性生理与慢性健康(acute physiology and chronic health evaluation,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,差异均有统计学意义(均P<0.05);且ICU-AW组近期病死率高于非ICU-AW组(P<0.05),而远期病死率两组间差异无统计学意义(P>0.05);出院后6个月ICU-AW组生理功能评分低于非ICU-AW组(P<0.05)。结论 ICU获得性衰弱对重症患者的近远期预后均有影响,需要积极地采取措施对ICU-AW进行预防和治疗。

Objective To explore the effect of ICU-acquired weakness（ICU-AW）on the mortality of critically ill patients and the physiological function of survivors.Methods By using convenience sampling method,276 ICU patients were selected and divided into ICU-AW group and non-ICU-AW group based on the presence of ICU-AW.The number of recent deaths of participants was recorded.Survivors were assessed by using SF-36 health survey.Results Compared with non-ICU-AW group,ICU-AW group was older and had higher acute physiology and chronic health evaluation score,more infectious diseases,longer mechanical ventilation time and ICU admission time（all P〈0.05）.The short-term mortality of ICU-AW group was significantly higher than that of non-ICU-AW group（P〈0.05）,while no statistical significance of long-term mortality rate was found between two groups（P〈0.05）.The physiological function scores of ICU-AW group were significantly lower than that of non-ICU-AW group at 6 months after discharge（P〈0.05）.Conclusions ICU-acquired weakness has an impact on the short-term and long-term prognosis of critically ill patients and active measures are required to prevent and treat ICU-AW.