摘要
背景急性心力衰竭患者病情较严重,且患者转出重症监护病房(ICU)后的自理能力一般较差,但其具体影响因素尚不明确。目的调查急性心力衰竭患者转出ICU后7 d内自理能力并分析其影响因素。方法回顾性选取2015年6月—2019年12月唐山市协和医院ICU收治的264例急性心力衰竭患者,采用一般资料调查表、汉密尔顿抑郁量表(HAMD)、急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)及Barthel指数(BI)评定量表分别调查患者的一般资料、抑郁情况、APACHEⅡ评分及自理能力,并比较不同临床资料的急性心力衰竭患者转出ICU后7 d内BI评分。采用多元线性回归分析急性心力衰竭患者转出ICU后7 d内BI评分的影响因素。结果不同性别、年龄、婚姻状况、家庭人均月收入、纽约心脏病协会(NYHA)分级、机械通气方式、ICU入住时间、APACHEⅡ评分及是否使用镇静药物、行连续肾脏替代疗法(CRRT)、伴有抑郁的急性心力衰竭患者转出ICU后7 d内BI评分比较,差异有统计学意义(P<0.05)。多元线性回归分析结果显示,性别〔β=0.587,95%CI(0.168,0.875)〕、年龄〔β=-0.457,95%CI(-0.965,-0.216)〕、NYHA分级〔β=-0.745,95%CI(-2.364,-0.254)〕、机械通气方法〔β=-0.612,95%CI(-1.954,-0.116)〕、行CRRT〔β=-0.655,95%CI(-2.394,-0.075)〕、ICU入住时间〔β=-0.524,95%CI(-2.036,-0.214)〕、伴有抑郁〔β=-0.421,95%CI(-1.689,-0.139)〕、APACHEⅡ评分〔β=-0.236,95%CI(-0.824,-0.044)〕是急性心力衰竭患者转出ICU后7 d内BI评分的影响因素(P<0.05)。结论急性心力衰竭患者转出ICU后7 d内自理能力较差,性别、年龄、NYHA分级、机械通气方式、行CRRT、ICU入住时间、抑郁、APACHEⅡ评分是其转出ICU后7 d内自理能力的影响因素。
Background Patients with acute heart failure are seriously ill,and the self-care ability is poor after the patient transferred out of ICU,but the influencing factors are not clear.Objective To investigate the self-care ability of patients with acute heart failure within 7 days after being transferred from ICU and analyze its influencing factors.Methods In this retrospective study,264 patients with acute heart failure admitted to the ICU of Tangshan Union Hospital from June 2015 to December 2019 were enrolled.The general information questionnaire,Hamilton Depression Scale(HAMD),Acute Physiology and Chronic Health Status Rating SystemⅡ(APACHEⅡ)and Barthel Index(BI)rating scale were used to investigate the general information,depression,APACHEⅡscore and self-care ability,respectively.The comparations of BI scores for patients with acute heart failure in different clinical data.Multiple linear regression was used to analyze the influencing factors of BI score of patients with acute heart failure within 7 days after being transferred from the ICU.Results The BI scores that were for the following groups:gender,age,marital status,monthly household income per capita,New York Heart Association(NYHA)classification,mechanical ventilation,ICU stay time,APACHEⅡscore,whether it is accompanied by application of sedative drugs,continuous renal replacement therapy or depression were statistically different,respectively(P<0.05).The influencing factors were gender〔β=0.587,95%CI(0.168,0.875)〕,age〔β=-0.457,95%CI(-0.965,-0.216)〕,NYHA classification〔β=-0.745,95%CI(-2.364,-0.254)〕,mechanical ventilation methods〔β=-0.612,95%CI(-1.954,-0.116)〕,CRRT〔β=-0.655,95%CI(-2.394,-0.075)〕,ICU stay time〔β=-0.524,95%CI(-2.036,-0.214)〕,with depression〔β=-0.421,95%CI(-1.689,-0.139)〕,APACHEⅡscore〔β=-0.236,95%CI(-0.824,-0.044)〕were related to the BI score of patients with acute heart failure(P<0.05).Conclusion Patients with acute heart failure have poor self-care ability within 7 days after being transfer
作者
苑振飞
高学民
李卓隽
王跃
杨小军
刘华
YUAN Zhenfei;GAO Xuemin;LI Zhuojuan;WANG Yue;YANG Xiaojun;LIU Hua(Department of Critical Care Medicine,Tangshan Union Medical College Hospital,Tangshan 063000,China)
出处
《实用心脑肺血管病杂志》
2020年第11期96-100,共5页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
