脓毒症后综合征患者症状特征的潜在类别分析

doi:10.3761/j.issn.2096-7446.2024.03.001

摘要/Abstract

摘要： 目的探讨脓毒症后综合征患者症状的潜在类别,并分析不同潜在类别的影响因素。方法采用便利抽样方法,选取2021年1月—7月在福建省某三级甲等综合医院出院的脓毒症患者,患者出院后第3个月通过门诊及电话、微信视频相结合的方式进行问卷调查。对脓毒症后综合征患者的症状特征进行潜在类别分析,并通过单因素分析和多项分类Logistic回归识别其潜在类别的影响因素。结果共纳入347例脓毒症出院患者,其中216例（62.25%）发生脓毒症后综合征,出院后3个月认知障碍发生率为67.12%,焦虑发生率为61.57%,抑郁发生率为51.78%,睡眠障碍发生率为78.70%,日常生活能力障碍发生率为56.48%;脓毒症后综合征患者症状特征分别为“高症状组”（占比25.93%）、“认知—日常生活能力障碍组”（占比32.87%）和“睡眠障碍组”（占比41.20%）;有既往史、使用镇痛药物越多归于“高症状组”的概率越大,APACHEⅡ评分越高归于“高症状组”与“认知—日常生活能力障碍组”的概率越大,社会支持水平越高的归于“高症状组”与“认知—日常生活能力障碍组”的概率越小,激素药物使用越多归于“睡眠障碍组”的概率越小。结论脓毒症后综合征患者症状特征可分为“高症状组”“认知—日常生活能力障碍组”“睡眠障碍组”3个潜在类别,既往史、镇痛药物及激素使用、APACHEⅡ评分、社会支持等因素在各潜在类别中存在异质性,可以预测各症状潜在类别的归属。

关键词: 脓毒症后综合征, 潜在类别分析, 症状体验模型, 危重病护理

Abstract: Objective To explore the latent classes of symptoms in patients with post-sepsis syndrome, and to analyze the factors affecting the different classes. Methods Convenience sampling method was used to select sepsis patients discharged from a tertiary Grade A general hospital in Fujian Province from January 2021 to July 2021. Questionnaire survey was conducted three months after discharge through outpatient department, telephone and wechat. The latent classes of symptoms were analyzed,and the influencing factors were identified by univariate analysis and multinomial Logistic regression. Results Among 347 discharged patients with sepsis, 216 cases (62.25%) developed post-sepsis syndrome, and the incidence of cognitive impairment 67.12%,anxiety 61.57%, depression 51.78%,and sleep disorder 78.70% three months after discharge. The incidence of disability of daily living was 56.48%. The symptoms of post-sepsis syndrome patients were “high symptom group”（25.93%）,“cognitive daily living impairment group”（32.87%） and “sleep disorder group”（41.20%）. The odds of patients having a previous history and using more analgesics were greater in the “high symptom group”, the odds of having a higher APACHEⅡ score in the “high symptom group” and “cognitive-daily living impairment group” were greater, and the odds of having a higher level of social support in the “high symptom group” and “cognitive-daily living impairment group” were lower. The higher the use of hormone medication, the lower the risk of being classified as “sleep disorder group”. Conclusion The symptoms of patients with post-sepsis syndrome can be divided into three latent classes：“high symptom group” “cognitive-daily living impairment group” and “sleep disorder group”. There is heterogeneity in the latent classes of symptoms of patients with post-sepsis syndrome concerning previous history, analgesic drug use, hormone drug use, APACHEⅡscore and social support. The latent classes of symptoms can be predicted.

Key words: Post-sepsis Syndrome, Latent Class Analysis, Symptom Experience Model, Critical Care Nursing

陈玉珍, 郑剑煌, 姜志钊, 郑雪兰, 郑翠红. 脓毒症后综合征患者症状特征的潜在类别分析[J]. 中华急危重症护理杂志, 2024, 5(3): 197-204.

CHEN Yuzhen, ZHENG Jianhuang, JIANG Zhizhao, ZHENG Xuelan, ZHENG Cuihong. Latent class analysis of symptom characteristics in patients with post-sepsis syndrome[J]. Chinese Journal of Emergency and Critical Care Nursing, 2024, 5(3): 197-204.

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