ICU患者住院期间肢体握力及拉力的变化趋势

doi:10.3877/cma.j.issn.2096-1537.2021.02.010

目的

研究ICU患者住院期间肢体握力（上肢）及拉力（下肢）变化水平。

方法

收集2019年4至7月我院ICU 77例患者，每日测量其上肢握力及下肢拉力，直至出ICU。比较患者入ICU 3、7、10 d及出ICU时同一侧握力及拉力间的差异。

结果

患者入ICU 3 d（58例）、7 d（24例）、10 d（18例）内握力比较，差异无统计学意义（P＞0.05）；患者入ICU 3 d拉力比较，差异有统计学意义（P＜0.05），患者入ICU 7、10 d内拉力比较，差异无统计学意义（P＞0.05）；患者入ICU（77例）与出ICU（77例）时握力及拉力比较，差异有统计学意义（P＜0.05）。较入ICU时，出ICU时握力平均增加17.2%；出ICU时拉力平均增加41.3%。

结论

患者在入住ICU期间，其握力及拉力变化趋势并不明显，但仍需医护人员关注。

关键词: ICU患者, 握力拉力, 肌力水平

Objective

To understand the change of grip strength (upper limb) and tension (lower limb) in intensive care unit (ICU) patients during hospitalization.

Methods

Seventy-seven ICU patients from April 2019 to July 2019 received grip strength and lower limb tension assessments until they discharged from the ICU. The differences of grip strength and tension between patients on 3, 7 and 10 days after ICU admission and the point of ICU discharge were compared.

Results

There was no significant difference of grip strength among 3, 7 and 10 days after ICU admission. There was a differed significantly in the tension of patients within 3 days after admission (P＜0.05), and no difference in the tension within 7 and 10 days after admission. There were significant differences in grip strength between ICU admission and ICU discharge (P＜0.05). There were differences in tension between ICU admission and ICU discharge (P＜0.05). The grip strength increased by 17.2% on average and the lower limb tension increased by 41.3% on average when the patients discharged from the ICU.

Conclusion

During the period of admission to the ICU, the change trend of the patient's grip strength and tension is not obvious, but it still needs the attention of the medical staff.

Key words: ICU patients, Grip tension, Muscle strength

表1 患者入ICU 3 d内握力及拉力比较（kg，

x ˉ

±s，58例）

测量肢体	1 d内	2 d内	3 d内	F值	P值
左上肢握力	13.86±9.83	14.46±11.52	14.80±11.34	0.747	0.450
右上肢握力	14.53±10.62	15.40±11.90	15.74±12.33	1.171	0.302
左下肢拉力	5.70±5.19	6.48±5.88^a	7.48±6.58^ab	15.001	＜0.001
右下肢拉力	4.81±4.59	6.02±5.24^a	6.89±6.38^ab	15.130	＜0.001

表1 患者入ICU 3 d内握力及拉力比较（kg，

x ˉ

±s，58例）

测量肢体	1 d内	2 d内	3 d内	F值	P值
左上肢握力	13.86±9.83	14.46±11.52	14.80±11.34	0.747	0.450
右上肢握力	14.53±10.62	15.40±11.90	15.74±12.33	1.171	0.302
左下肢拉力	5.70±5.19	6.48±5.88^a	7.48±6.58^ab	15.001	＜0.001
右下肢拉力	4.81±4.59	6.02±5.24^a	6.89±6.38^ab	15.130	＜0.001

表2 患者入ICU 7 d内握力及拉力比较（kg，

x ˉ

±s，24例）

测量肢体	1 d内	2 d内	3 d内	4 d内	5 d内	6 d内	7 d内	F值	P值
左上肢握力	14.01±12.42	13.17±12.17	13.81±11.58	14.32±12.04	14.62±12.51	15.96±12.97	15.95±14.02	1.707	0.174
右上肢握力	14.73±13.41	14.02±12.11	14.09±11.96	15.81±12.39	15.50±13.13	15.84±11.92	16.30±13.86	1.031	0.378
左下肢拉力	4.61±4.27	4.89±4.34	5.93±4.83	6.42±4.98	6.17±4.83	6.71±5.28	6.26±5.60	4.321	0.014
右下肢拉力	3.94±3.59	4.63±3.66	5.47±4.98	5.92±5.65	5.65±4.98	5.97±5.37	5.93±5.82	4.996	0.004

表2 患者入ICU 7 d内握力及拉力比较（kg，

x ˉ

±s，24例）

测量肢体	1 d内	2 d内	3 d内	4 d内	5 d内	6 d内	7 d内	F值	P值
左上肢握力	14.01±12.42	13.17±12.17	13.81±11.58	14.32±12.04	14.62±12.51	15.96±12.97	15.95±14.02	1.707	0.174
右上肢握力	14.73±13.41	14.02±12.11	14.09±11.96	15.81±12.39	15.50±13.13	15.84±11.92	16.30±13.86	1.031	0.378
左下肢拉力	4.61±4.27	4.89±4.34	5.93±4.83	6.42±4.98	6.17±4.83	6.71±5.28	6.26±5.60	4.321	0.014
右下肢拉力	3.94±3.59	4.63±3.66	5.47±4.98	5.92±5.65	5.65±4.98	5.97±5.37	5.93±5.82	4.996	0.004

表3 患者入ICU 10 d内握力及拉力比较（kg，

x ˉ

±s，18例）

测量肢体	1 d内	2 d内	3 d内	4 d内	5 d内	6 d内	7 d内	8 d内	9 d内	10 d内	F值	P值
左上肢握力	10.97±8.59	9.82±5.91	9.92±6.15	9.51±5.46	9.56±6.29	11.22±7.56	11.14±10.35	10.12±10.90	8.93±9.39	8.69±9.36	0.514	0.686
右上肢握力	11.44±9.87	10.38±5.25	9.78±6.21	11.34±6.68	11.09±7.98	11.64±7.50	11.65±10.19	9.89±8.88	10.47±11.38	10.13±11.48	0.293	0.852
左下肢拉力	4.08±1.26	4.60±1.87	5.28±2.18	5.24±2.60	4.51±2.74	5.17±3.71	4.15±3.79	4.76±3.88	4.64±4.62	5.27±5.37	0.664	0.559
右下肢拉力	3.27±1.55	4.23±2.27	4.54±2.69	4.77±2.99	4.32±2.96	4.73±3.84	4.24±3.91	4.15±3.43	4.43±4.18	5.29±5.87	0.941	0.425

表3 患者入ICU 10 d内握力及拉力比较（kg，

x ˉ

±s，18例）

测量肢体	1 d内	2 d内	3 d内	4 d内	5 d内	6 d内	7 d内	8 d内	9 d内	10 d内	F值	P值
左上肢握力	10.97±8.59	9.82±5.91	9.92±6.15	9.51±5.46	9.56±6.29	11.22±7.56	11.14±10.35	10.12±10.90	8.93±9.39	8.69±9.36	0.514	0.686
右上肢握力	11.44±9.87	10.38±5.25	9.78±6.21	11.34±6.68	11.09±7.98	11.64±7.50	11.65±10.19	9.89±8.88	10.47±11.38	10.13±11.48	0.293	0.852
左下肢拉力	4.08±1.26	4.60±1.87	5.28±2.18	5.24±2.60	4.51±2.74	5.17±3.71	4.15±3.79	4.76±3.88	4.64±4.62	5.27±5.37	0.664	0.559
右下肢拉力	3.27±1.55	4.23±2.27	4.54±2.69	4.77±2.99	4.32±2.96	4.73±3.84	4.24±3.91	4.15±3.43	4.43±4.18	5.29±5.87	0.941	0.425

表4 患者入ICU第1天与出ICU时握力及拉力比较（kg，

x ˉ

±s）

测量肢体	第1天	出ICU时	t值	P值
左上肢握力	14.02±9.86	16.19±12.91	2.134	0.036
右上肢握力	14.46±10.78	17.19±13.54	2.490	0.015
左下肢拉力	5.90±5.28	8.65±7.49	4.605	＜0.001
右下肢拉力	4.79±4.57	7.74±7.48	4.090	＜0.001

表4 患者入ICU第1天与出ICU时握力及拉力比较（kg，

x ˉ

±s）

测量肢体	第1天	出ICU时	t值	P值
左上肢握力	14.02±9.86	16.19±12.91	2.134	0.036
右上肢握力	14.46±10.78	17.19±13.54	2.490	0.015
左下肢拉力	5.90±5.28	8.65±7.49	4.605	＜0.001
右下肢拉力	4.79±4.57	7.74±7.48	4.090	＜0.001

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Variation trend of the strength of grip and tension in ICU patients during hospitalization

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Variation trend of the strength of grip and tension in ICU patients during hospitalization