呼吸监护室危重症患者ICU后综合征发生现状及危险因素分析

目的调查呼吸监护室危重症患者ICU后综合征的发生现状,探讨ICU后综合征发生的影响因素。方法采取便利抽样方法,抽取在北京市某三级甲等医院ICU病房进行住院治疗后转出的ICU患者共125例。采用由简易精神状态量表、监护室谵妄评估量表、住院焦虑抑郁量表、日常生活活动能力量表、匹兹堡睡眠质量指数量表、疲劳量表-14对患者认知、心理、生理三方面评估进行ICU后综合征的诊断。采用研究者自行设计的患者一般资料调查表和疾病相关资料调查表对ICU后综合征的影响因素进行测量。结果本研究实际有效样本量为110例,有59例发生ICU后综合征,发生率为53.6%。Logistic回归分析显示,ICU后综合征的影响因素分别为年龄、有创机械通气时间、无创呼吸机辅助通气时间、冠状动脉粥样硬化性心脏病(P<0.05)。结论 ICU患者ICU后综合征的发生率为53.6%,处于较高水平。高龄、有创机械通气时间长、无创呼吸机辅助通气时间长、患有冠状动脉粥样硬化性心脏病是ICU后综合征的危险因素。医护人员应加大对ICU后综合征的重视,对患者存在的危险因素进行干预,以预防ICU后综合征的发生。

The current situation and the effect factors of post-intensive care syndrome among patients in RICU

Objective To survey the current situation of post-intensive care syndrome(PICS) among patients in respiratory intensive care unit(RICU), and explore the effect factors of PICS. Methods By convenience sampling, 125 patients in the RICU of Peking University First Hospital were recruited in the study. The patients were tested for PICS using Mini-mental State Examination(MMSE), Confusion Assessment Method for the ICU(CAM-ICU), Hospital Anxiety and Depression Scale(HADS), Medical Research Council(MRC), Activities of Daily Living(ADL), Pittsburg Sleep Quality Index(PSQI), Fatigue Scale-14(FS-14), including three aspects of cognition, psychology and physiology.The effect factors of PICS were measured through researcher-created Questionnaire on Patients’ General Information and Questionnaire on Disease-Related Information. Results In this study, the actual effective sample size was 110 cases,among which 59 cases developed PICS, with an incidence of 53.6%. Logistic regression showed that effect factors of PICS were age, invasive mechanical ventilation time, noninvasive ventilator assisted ventilation time and coronary atherosclerotic heart disease(P< 0.05). Conclusions The incidence of PICS in RICU patients is 53.6%, which is at a high level. Advanced age, long duration of invasive mechanical ventilation, long duration of non-invasive ventilator assisted ventilation, and coronary atherosclerotic heart disease are the risk factors of PICS. Medical and nursing staff should pay more attention to PICS, intervene in the risk factors of the patient, and take targeted measures to prevent the occurrence of PICS.