摘要
目的 病例回顾视角下分析行连续性肾脏替代治疗(CRRT)脓毒症患者重症监护病房获得性衰弱(ICU-AW)发生现况及影响因素.方法 回顾性收集2022年1月-2024年8月绵阳市中心医院行CRRT脓毒症患者200例作为研究对象,统计ICU-AW发生率,并以是否发生ICU-AW将患者分为ICU-AW组(n=84)、非ICU-AW组(n=116).收集患者个人情况以及相关临床资料,包括性别、年龄、急性生理学与慢性健康状况Ⅱ评分、机械通气时间、营养方式、脓毒性休克、血乳酸水平等.对两组资料进行单因素和多因素Logistic回归分析ICU-AW发生的影响因素.结果 200例行CRRT脓毒症患者中,ICU-AW发生84例,发生率为42%.单因素分析,性别、体质量指数、婚姻状况、ICU住院时间、营养方式、是否使用激素无统计学差异(P均>0.05),年龄、APACHEⅡ评分、机械通气时间、营养不良、脓毒性休克、血乳酸水平有统计学差异(P均<0.05).多因素分析,年龄≥60岁、APACHEⅡ评分>20、机械通气时间≥7d、营养不良、发生脓毒性休克、血乳酸水平升高是ICU-AW发生的独立危险因素(P均<0.05).结论 行CRRT脓毒症患者中,ICU-AW发生率较高,且受到多种因素影响,科室相关医护人员应对相关危险因素给予重视,加强预防与管理,减少ICU-AW的发生.
Objective To analyze the current status and influencing factors of intensive care unit acquired weakness(ICU-AW)in sepsis patients treated with continuous renal replacement therapy(CRRT)from the perspective of case review.Methods A total of 200 patients with sepsis who underwent CRRT in Mianyang Central Hospital from January 2022 to August 2024 were retrospectively collected as the research objects.The incidence of ICU-AW was counted,and the patients were divided into ICU-AW group(n=84)and non-ICU-AW group(n=116)according to whether ICU-AW occurred.Personal information and related clinical data of patients were collected,including gender,age,acute physiology and chronic health evaluationⅡ(APACHE II)score,duration of mechanical ventilation,nutritional mode,septic shock,and blood lactic acid level.Univariate and multivariate Logistic regression analysis were used to analyze the influencing factors of ICU-AW.Results Among the 200 patients with sepsis who underwent CRRT,84 patients developed ICU-AW,with an incidence of 42%.Univariate analysis showed that there were no significant differences in gender,body mass index,marital status,length of ICU stay,nutritional mode,and use of hormones(all P>0.05),while there were significant differences in age,APACHEⅡscore,mechanical ventilation time,malnutrition,septic shock,and blood lactic acid level(all P<0.05).Multivariate analysis showed that age≥60 years,APACHEⅡscore>20,mechanical ventilation time≥7days,malnutrition,septic shock,and increased blood lactic acid level were independent risk factors for ICU-AW(all P<0.05).Conclusion The incidence of ICU-AW in sepsis patients undergoing CRRT is high and is affected by many factors.The relevant medical and nursing staff of the department should pay attention to the above risk factors,strengthen prevention and management,and reduce the occurrence of ICU-AW.
作者
张瑞
Zhang Rui(Mianyang Central Hospital,School of Medicine,University of Electronic Science and Technology of China,Mianyang,Sichuan 621000,China)
出处
《首都食品与医药》
2025年第5期45-47,共3页
Capital Food Medicine
关键词
脓毒症
连续性肾脏替代治疗
重症监护病房获得性衰弱
影响因素
sepsis
Continuous renal replacement therapy
Intensive care unit acquired weakness
Influencing factors
