ICU获得性衰弱对重症患者近远期预后的影响

摘要

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 and 2016.3.31 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-ICU-AW 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.%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ICU-AW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ICU-AW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.