危重症患者并发ICU获得性衰竭现状及影响因素分析

Status and Influence Factors of Critically Ill Patients with ICU Acquired Weakness

目的探讨危重症患者并发ICU获得性衰竭的影响因素,并提出预防对策。方法选择2014年1月—2016年12月入住我院ICU的危重症患者235例,并发ICU获得性衰竭135例患者为病例组,无并发ICU获得性衰竭100例患者为对照组,对引起ICU获得性衰竭的影响因素进行多因素Logistic回归分析。结果多因素Logistic回归分析显示,脓毒症、多器官功能障碍综合征、机械通气时间、平均动脉压低于基础血压水平百分比、平均血糖水平高于基础血糖水平百分比、制动、镇静是危重症患者并发ICU获得性衰竭的独立危险因素(P<0.05)。结论危重症患者并发ICU获得性衰竭发生率较高,加强液体管理、做好器官维护、强化呼吸功能锻炼、维持正常血压水平、控制血糖、早期活动、优化镇静方案对降低危重症患者并发ICU获得性衰竭发生率具有重要意义。

Objective To study the status and influence factors of critically ill patients with ICU acquired weakness(ICU-AW),and propose prevention strategies.Methods A total of 235 critically ill patients in ICU from January,2014 to December,2016 were selected and 135 patients with ICU-AW were selected as the case group and 100 patients without as the control group.Logistic regression analysis was used to study the influence factors of ICU-AW.Results The independent risk factors of critically ill patients with ICU-AW included sepsis,MODS,the length of mechanical ventilation,the percentage of MAP lower than basic blood pressure,the percentage of mean blood sugar higher than basic blood sugar,immobility and sedation(P<0.05).Conclusion The incidence rate of ICU-AW in critically ill patients is high and we should enhance the fluid management and respiratory training,maintain the function of organs,normal blood pressure and normal blood sugar,encourage early mobility and optimize the sedative scheme.