机械通气患者并发ICU获得性衰弱的现状调查及高危因素分析-现代医学

机械通气患者并发ICU获得性衰弱的现状调查及高危因素分析

单位：1. 宿迁市第一人民医院重症医学科, 江苏宿迁 223800;
2. 宿迁市第一人民医院护理部, 江苏宿迁 223800;
3. 宿迁市第一人民医院泌尿外科, 江苏宿迁 223800

分类号：R459.4

出版年·卷·期（页码）：2020·48·第一期（50-56）

摘要：

目的： 探讨机械通气患者并发ICU获得性衰弱（ICU-acquired weakness，ICU-AW）的高危影响因素及现状，为有效预防ICU获得性衰弱的发生提供临床参考依据。方法： 回顾性分析2017年6月至2018年12月，入住我院重症监护室255例机械通气患者，根据是否发生ICU-AW分为两组，通过调查问卷的方式收集研究对象的一般资料和临床特征，并采用无序多分类Logistic回归分析其并发ICU-AW的高危因素。方法： 调查显示，255例研究对象中有139名患者并发ICU-AW，发病率为54.51%。Logistic回归分析结果显示，脓毒血症、多器官功能障碍、糖皮质激素、机械通气时间、乳酸水平、镇痛镇静及连续肾脏替代治疗是机械通气患者并发ICU-AW的独立危险因素。方法： 机械通气患者ICU-AW发病率较高，且高危影响因素较多，需积极治疗控制原发疾病，去除相关危险因素，以降低ICU-AW的发病率。

Objective: To investigate the status and influence factors of ICU acquired weakness(ICU-AW) in critically ill patients with mechanical ventilation, and propose prevention strategies, in order to providing clinical reference basis. Methods: A total of 255 critically ill patients in ICU from June, 2017 to December, 2018 were selected and divided into ICU-AW group and non-ICU-AW group based on presence of ICU-AW. Questionnaire was used to collect general data and clinical characteristics. Logistic regression analysis was used to study the influence factors of ICU-AW. Results: In 255 cases, 139 cases of patients had concurrent ICU-AW, the incidence of acquired weakness was 54.51%. Logistic regression result showed that:sepsis, MODS, the use of glucocorticoid treatment, the length of mechanical ventilation, the level of blood lactic acid, immobility and sedation, the continuous renal replacement therapy(P<0.05). Conclusion: The incidence rate of ICU-AW in critically ill patients is high, it is associate with various factors. It is needed to actively treat primary disease and to identify the high risk patients, and active measures are required to prevent ICU-AW.

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