神经重症患者获得性衰弱的影响因素分析

Analysis of factors influencing acquired frailty in severe neurological patients

目的分析神经重症患者获得性衰弱的影响因素。方法选择2020年1月—2022年12月该院收治的210例神经重症患者临床资料进行回顾性分析,根据是否发生获得性衰弱分组,未发生获得性衰弱为对照组,共114例,发生获得性衰弱为观察组,共96例,收集患者一般资料,分析患者发生获得性衰弱的影响因素。结果单因素分析发现,二组患者在年龄(t=23.085,P<0.001)、入住ICU时间(χ^(2)=76.845,P<0.001)、营养不良(χ^(2)=24.868,P<0.001)、APACHEⅡ评分(χ^(2)=82.558,P<0.001)、神经肌肉阻滞剂使用时间(χ^(2)=45.311,P<0.001)、机械通气时间(χ^(2)=43.410,P<0.001)、每日唤醒(χ^(2)=28.250,P<0.001)、合并脓毒症(χ^(2)=55.724,P<0.001)等方面比较差异有统计学意义(均P<0.05);多因素Logistic回归分析发现,年龄、入住ICU时间、营养不良、APACHEⅡ评分、神经肌肉阻滞剂使用时间、机械通气时间、每日唤醒、合并脓毒症等方面比较差异有统计学意义(均P<0.05)。结论神经重症患者发生获得性衰弱的影响因素复杂多样,多与年龄、入住ICU时间、营养不良、APACHEⅡ评分、神经肌肉阻滞剂使用时间、机械通气时间、每日唤醒、合并脓毒症等临床因素相关,应加以重视,给予针对性干预,减少或避免获得性衰弱发生。

Objective To analyze the influencing factors of acquired weakness in neurosevere patients.Methods From January 2020 to December 2022,the clinical data of two hundred and ten patients with severe neurological disease were analyzed retrospectively.According to whether acquired frailty occurred,one hundred and fourteen cases without acquired weakness as control group and ninety-six cases with acquired frailty as observation group,and the relevant data of patients were collected and analyzed the influencing factors of acquired frailty in patients.Results Univariate analysis showed significant differences in age(t=23.085,P<0.001),ICU stay time(χ^(2)=76.845,P<0.001),malnutrition(χ^(2)=24.868,P<0.001),APACHEⅡscore(χ^(2)=82.558,P<0.001),Duration of neuromuscular blockers(χ^(2)=45.311,P<0.001),mechanical ventilation time(χ^(2)=43.410,P<0.001),daily awakening(χ^(2)=28.250,P<0.001),and sepsis(χ^(2)=55.724,P<0.001).Multifactor Logistic regression linear analysis showed significant differences in age,ICU stay time,malnutrition,APACHEⅡscore,Duration of neuromuscular blockers,mechanical ventilation time,daily awakening,and sepsis(P<0.05).Conclusion Severe patients with acquired weak influence factors of complex and diverse.Age,ICU stay time,malnutrition,APACHEⅡscore,Duration of neuromuscular blockers,mechanical ventilation time,daily awakening,sepsis and other clinical factors,should be paid attention to,give targeted intervention to reduce or avoid acquired frailty.