老年人重症肺部感染APACHE Ⅱ评分的临床价值  

CLINICAL VALUE OF APACHE Ⅱ SCORE IN SEVERE PULMONARY INFECTION OF THE ELDERLY

作　　者：蒋军广[1] 帖永新[2] 谭伟丽[1] 蒋丽红 翟建霞[2] 王丽华[2] 

机构地区：[1]郑州大学第一附属医院-河南省高等学校临床医学重点学科开放实验室,郑州450052 [2]郑州大学 [3]长葛市人民医院

出　　处：《现代预防医学》2007年第23期4420-4421,共2页Modern Preventive Medicine

基　　金：河南省医药卫生科研重点项目(03121)

摘　　要：[目的]准确评估老年人重症肺部感染的危重程度及预后。[方法]对老年人重症肺部感染患者进行回顾性分析,采用急性生理改变与慢性健康评估系统(APACHEⅡ)对疾病的危重程度进行评分。[结果]全组APACHEⅡ评分均值为21.5分。57例死亡患者为24.4分,明显高于123例存活患者的18.1分(P﹤0.01)。经治疗5 d后,存活组评分明显下降,死亡组评分明显升高(P均﹤0.01)。随着APACHEⅡ评分增高,并发症发生率从7.1%升至80.0%;病死率从0逐渐升高至100.0%(P均﹤0.01)。[结论]APACHEⅡ评分系统是评估老年人重症肺部感染病情危重程度预后的较好指标,值得在临床工作中推广使用。[Objective]To evaluate the severity and the prognosis of severe pulmonary infection in the elderly patients.[Methods]A retrospective study conducted in 180 elderly patients with severe pulmonary infection,the acute physiology and chronic health evaluation Ⅱ（APACHE Ⅱ）were used to quantify the severity of illness and to judge the outcome.[Results]The average APACHE Ⅱ score of these patients was 21.5.APACHE Ⅱ score showed a difference between the fatal patients（24.4）and survivors（18.1）.After 5 days＇ treatment,the score of survivors descended obviously and the score of dead patients ascended（P﹤0.01）.With the increase of APACHEⅡ score,the incidence of complication ascended from 7.1% to 80.0%,the mortality ascended gradually from 0 to 100.0%（P﹤0.01）.[Conclusion]For severe pulmonary infection in the elderly patients,the system of APACHEⅡscore is value in predicting the outcome and estimaling the quality of life.

关 键 词：肺部感染 老年人 预后 APACHEⅡ评分 

分 类 号：R563[医药卫生—呼吸系统]