ISSN 2097-6046（网络）
ISSN 2096-7446（印刷）
CN 10-1655/R
主管：中国科学技术协会
主办：中华护理学会
中华急危重症护理杂志

中华急危重症护理杂志 ›› 2026, Vol. 7 ›› Issue (6): 653-659.doi: 10.3761/j.issn.2096-7446.2026.06.002

• 论著 • 上一篇    下一篇

不同性别ICU患者ICU后综合征各领域症状的纵向关系研究

张立文1(), 董春利2, 崔翔宇3, 张文博2, 高泷4,*()   

  1. 1 济宁医学院附属医院重症医学科 山东省济宁市 272000
    2 山东第一医科大学护理学院 泰安市 271016
    3 滕州市中心人民医院呼吸重症监护室 山东省枣庄市 277599
    4 南昌大学江西医学院护理学院 南昌市 330019
  • 收稿日期:2025-06-23 出版日期:2026-06-10 发布日期:2026-06-02
  • 通讯作者: 高泷 E-mail:zhangliwen429@163.com;gaosx0707@163.com
  • 作者简介:张立文：男，本科，副主任护师，护士长，E-mail：zhangliwen429@163.com
    第一联系人：

    张立文：实施研究、论文撰写、经费支持；董春利：实施研究、数据整理；崔翔宇：实施研究、统计学分析；张文博：数据整理；高泷：研究指导、论文修改

  • 基金资助:
    济宁市重点研发项目（软科学项目）(2020JNZC034)

A longitudinalstudy on the symptoms of post-intensive care syndrome domains in ICU patients of different genders

ZHANG Liwen1(), DONG Chunli2, CUI Xiangyu3, ZHANG Wenbo2, GAO Shuang4,*()   

  1. 1 Intensive Care Unit， Affiliated Hospital of Jining Medical University，Jining， Shandong province 272000， China
    2 School of Nursing， Shandong First Medical University & Shandong Academy of Medical Sciences， Taian 271016， China
    3 Respiratory Intensive Care Unit， Tengzhou Central People’s Hospital，Zaozhuang， Shandong province 277599， China
    4 School of Nursing， Jiangxi Medical College，Nanchang University， Nanchang 330019， China
  • Received:2025-06-23 Online:2026-06-10 Published:2026-06-02
  • Contact: GAO Shuang E-mail:zhangliwen429@163.com;gaosx0707@163.com
  • Supported by:
    Jining Key Research and Development Project（Soft Science Project）(2020JNZC034)

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摘要：

目的 在性别视角下，调查ICU患者转出ICU后3个月内ICU后综合征（post-intensive care syndrome，PICS）认知、生理、心理领域功能障碍的纵向关系，明确性别的调节作用。 方法 采用便利抽样法，选取2023年9月—2024年2月在山东省某三级甲等医院内科、外科ICU收治并成功转出的584例危重症患者作为研究对象，按性别进行分组，对其转出ICU后1个月（T1）和3个月（T2）的认知、生理、心理功能障碍状况进行评估。构建交叉滞后模型探索PICS 3个领域的纵向关系及性别差异。 结果 两次随访的PICS严重程度有下降趋势（Z=-7.431，P<0.01），且该趋势在不同性别群体中一致。认知、生理、心理功能障碍之间的纵向关系通过自回归效应稳定维持（β=0.55、0.51、0.39），认知、生理、心理功能障碍水平在两次评估中均呈正相关。交叉滞后模型分析显示，T1时的认知功能障碍对T2时的生理功能障碍的预测作用在男女群体中均有具有统计学意义。T1时的生理功能障碍对T2时的认知和心理功能障碍的预测仅在男性中有统计学意义。 结论 ICU患者转出ICU后3个月内的认知、生理、心理功能障碍在不同性别中有不同的纵向关系。基于性别对ICU患者进行早期、针对性的干预可有效预防后期功能障碍的发生、维持和恶化。

关键词: 认知功能障碍, 生理功能障碍, 心理功能障碍, ICU后综合征, 交叉滞后模型, 纵向研究

Abstract:

Objective From a gender perspective，to investigate the longitudinal relationships between cognitive，physical，and psychological dysfunction of post-intensive care syndrome（PICS）among ICU survivors within 3 months after being transferred out of the ICU，and clarify the moderating role of gender. Methods 584 critically ill patients transferred from medical and surgical ICUs of a tertiary grade-A hospital in Shandong Province（September 2023-February 2024） was included by convenient sampling. They were grouped by gender，and their cognitive，physical，and psychological dysfunction were assessed at 1 month （T1） and 3 months （T2） post-ICU discharge. A cross-hysteresis model was constructed to explore the longitudinal relationship and gender difference between the three domains of PICS. Results The severity of PICS at the two follow-ups showed a downward trend（Z=-7.431，P <0.01），and this trend was consistent among different gender groups. Autoregressive effects stably maintained longitudinal relationships among the three dysfunctions（β=0.55，0.51，0.39），with positive correlations observed at both time points. Cross-lagged analysis revealed that T1 cognitive impairment significantly predicted T2 physical impairment in both male and female groups. T1 physical impairment significantly predicted T2 cognitive and psychological impairments only in males. Conclusion Longitudinal relationships between cognitive，physical，and psychological impairments vary by sex within 3 months post-ICU discharge. Early and targeted interventions based on gender for ICU patients can effectively prevent the occurrence，maintenance，and deterioration of functional disorders in the later stages.

Key words: Cognitive Impairment, Physical Impairment, Psychological Impairment, Post-Intensive Care Syndrome, Cross-Lagged Panel Analysis, Longitudinal studies