ICU患者双上肢握力及髋关节屈曲拉力水平及其影响因素

目的调查ICU患者双上肢握力及髋关节屈曲拉力及其主要影响因素。 方法选取2019年4月至7月青海省人民医院77例ICU患者为研究对象，男性55例，女性22例，平均年龄（56.09±18.44）岁。收集患者一般病例资料（包括一般社会学资料，入住ICU后，出ICU前及出ICU时评价指标），测量其在入住ICU时和出ICU时双上肢握力及髋关节屈曲拉力。 结果患者入住ICU时及出ICU时，上肢握力分别为（22.14±10.91）kg、（23.22±12.01）kg，差异有统计学意义（t=2.490，P=0.015）；髋关节屈曲拉力分别为（9.99±6.23）kg、（11.14±7.87）kg，差异有统计学意义（t=4.605，P＜0.001）。患者出ICU时，ADL评分较入住ICU时有显著改善，差异有统计学意义（Z=4.401，P＜0.001），患者营养不良比例、红细胞、血红蛋白较入住ICU时有显著性下降，差异有统计学意义（χ²=65.07，t=5.208，t=2.688，P＜0.05），其余化验指标均无显著性改变（P＞0.05）。患者上肢握力与年龄（r=-0.540）、性别（r=-0.415）、婚姻状况（r=-0.512）、住ICU天数（r=-0.304）、机械通气天数（r=-0.246）、人工气道天数呈显著性负相关（r=-0.224），与ADL评分（r=0.316）呈显著正相关；髋关节屈曲拉力与性别（r=-0.452）、营养状态（r=-0.334）呈显著负相关。 结论ICU患者上肢握力及髋关节屈曲拉力呈现较低水平，随着疾病恢复逐渐增强。对于高龄、女性、有吸烟史、有饮酒史及已婚的患者在住ICU期间要更加关注其肌肉健康状态，患者住ICU期间要根据病情尽早拔除人工气道、缩短机械通气的时间，同时要加强患者的营养，为预防ICU患者肌肉衰减做好预防工作。

Investigation and characteristics analysis of limb muscle strength in ICU patients

ObjectiveTo investigate the grip strength and hip flexion and tension, and analyze the main factors that affect the muscle function of ICU patients. MethodsICU patients from Qinghai Provincial People's Hospital from April 2019 to July 2019 were included in this study. There were 55 males and 22 females with an average age of (56.09±18.44) years. The clinical data of general sociological date, post-ICU, pre-ICU, leaving ICU were collected and the grip strength and hip flexion tensile force of the patients at ICU admission and discharge were measured. ResultsThere were significant difference of grip strength and hip flexion tension of ICU patients between ICU admission and discharge grip strength: (22.14±10.91) kg vs (23.22±12.01) kg, t=2.490, P=0.015; hip flexion tension: (9.99±6.23) kg vs (11.14±7.87) kg, t=4.605, P＜0.001]. When the patient discharges from the ICU, the ADL score significantly improved (Z=4.401, P＜0.001) as well as the patient's malnutrition status, red blood cells, and hemoglobin (χ²=65.07, t=5.208, t=2.688, P＜0.05) while other laboratory results did not change significantly (P＞0.05). The patient's grip strength was significantly negatively correlated with age (r=-0.540), sex (r=-0.415), marital status (r=-0.512) duration of ICU stay (r=-0.304), mechanical ventilation (r=-0.246) and artificial airway (r=-0.224) while it positively correlated with ADL scores (r=0.316). The grip strength was significantly higher in male, single and no history of smoking and drinking. The patient's hip flexion tension was significantly negatively correlated with sex (r=-0.452) and nutritional status (r=-0.334). ConclusionsICU patients shows lower grip strength and hip flexion tension, which are gradually improved with the recovery. More attention should be paid to the muscle health status of elder, female, smoking, drinking, and married patients during ICU stay. Artificial airway should be removed as soon as possible and mechanical ventilation duration should be shortened according to patients' condition during ICU stay. Meanwhile, nutrition of patients should be strengthened to prevent muscle decay in ICU patients.