临床肺科杂志2025,Vol.30Issue(1) :70-73,82.DOI:10.3969/j.issn.1009-6663.2025.01.012

急性呼吸衰竭经ECMO治疗幸存者认知功能损害状况及影响因素分析

Status of cognitive impairment in survivors of acute respiratory failure treated with ECMO and analysis of its influencing factors

王红梅 刘艳 马晶 宋蓓 宋云林
临床肺科杂志2025,Vol.30Issue(1) :70-73,82.DOI:10.3969/j.issn.1009-6663.2025.01.012

急性呼吸衰竭经ECMO治疗幸存者认知功能损害状况及影响因素分析

Status of cognitive impairment in survivors of acute respiratory failure treated with ECMO and analysis of its influencing factors

王红梅 1刘艳 1马晶 1宋蓓 2宋云林1
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作者信息

  • 1. 830054 新疆乌鲁木齐,新疆医科大学第一附属医院重症医学科
  • 2. 830054 新疆乌鲁木齐,新疆医科大学第一附属医院护理部
  • 折叠

摘要

目的 调查急性呼吸衰竭(ARF)经体外膜肺氧合(ECMO)治疗幸存者的认知功能损害状况并分析影响因素,为筛查ARF经ECMO治疗幸存者认知功能损害高危人群及防治提供参考.方法 收集136例ARF经ECMO治疗幸存者,评估其认知功能,调查认知功能障碍发生情况.采用Logistic回归分析ARF经ECMO治疗幸存者认知功能障碍的影响因素.结果 ARF经ECMO治疗幸存者出院时、出院3个月、出院6个月和出院1年时认知功能障碍比例分别为64.7%、50.7%、44.1%和38.2%.Logistic回归分析显示,急性生理学与慢性健康状况评分Ⅱ(APACHE Ⅱ评分,OR=1.782)、序贯器官衰竭评分(SOFA评分,OR=1.665)、ECMO治疗时间(OR=2.321)和谵妄(OR=5.876)是ARF经ECMO治疗幸存者出院1年时认知功能障碍的危险因素(P<0.05).结论 ARF经ECMO治疗幸存者出院后1年内认知功能障碍比例逐渐降低,但仍有较大比例的幸存者面临长时间的认知功能障碍.APACHE Ⅱ评分、SOFA评分、ECMO治疗时间和谵妄是该部分幸存者面临长期认知功能障碍的危险因素,临床上可以筛选出具备这些特征的高危人群,并予以针对性干预.

Abstract

Objective To investigate the status of cognitive impairment in survivors of acute respiratory fail-ure(ARF)treated with extracorporeal membrane oxygenation(ECMO)and to analyze the influencing factors in order to provide reference for screening high-risk population of cognitive impairment and its prevention and treatment in these survivors.Methods 136 survivors of ARF treated with ECMO were collected,and their cognitive function were evaluated.The proportion of cognitive dysfunction was investigated.Logistic regression analysis was used to ana-lyze the influencing factors of cognitive dysfunction in survivors of ARF treated with ECMO.Results The proportion of cognitive dysfunction among survivors of ARF treated with ECMO at discharge,3 months,6 months and 1 year af-ter discharge was 64.7%,50.7%,44.1%and 38.2%,respectively.Logistic regression analysis showed that acute physiology and chronic health status score Ⅱ(APACHE Ⅱ score,OR=1.782),sequential organ failure score(SO-FA score,OR=1.665),ECMO treatment time(OR=2.321)and delirium(OR=5.876)were risk factors for cog-nitive dysfunction in survivors of ARF treated with ECMO 1 year after discharge(P<0.05).Conclusion The pro-portion of cognitive dysfunction among survivors of ARF treated with ECMO gradually decreased within one year after discharge,but a large proportion of survivors still faced long-term cognitive dysfunction.APACHE Ⅱ score,SOFA score,ECMO treatment time and delirium are risk factors for long-term cognitive dysfunction faced by these survivors.High risk populations with these characteristics can be screened clinically and targeted interventions can be given.

关键词

急性呼吸衰竭/体外膜肺氧合/幸存者/认知功能障碍/影响因素

Key words

acute respiratory failure/extracorporeal membrane oxygenation/survivor/cognitive dysfunc-tion/influencing factors

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出版年

2025
临床肺科杂志
安徽医科大学 解放军第105医院

临床肺科杂志

影响因子:1.42
ISSN:1009-6663
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