APACHEⅡ评分及氧合指数对急性呼吸窘迫综合征预后影响的分析  

Analysis of the Effects of APACHEⅡ Score and the Oxygenation Index on the Prognosis of the Acute Respiratory Distress Syndrome

作　　者：槐永军[1] 马壮[1] 史亮[1] 陈萍[1] 

机构地区：[1]解放军沈阳军区总医院呼吸内科,辽宁沈阳110016

出　　处：《临床军医杂志》2009年第4期624-626,共3页Clinical Journal of Medical Officers

摘　　要：目的探讨APACHEⅡ评分及氧合指数(PaO2/F iO2)对急性呼吸窘迫综合征(ARDS)患者预后的影响。方法收集我院呼吸内科重症监护室(R ICU)30例ARDS患者临床资料,根据患者临床预后分为死亡组及存活组,比较患者APACHEⅡ评分及PaO2/F iO2变化对临床预后的影响。结果死亡20例,存活10例。死亡组与存活组患者的APACHEⅡ评分、PaO2/F iO2基础值(确诊时)比较差异均无统计学意义(P>0.05)。APACHEⅡ评分:死亡组与存活组治疗后第5、7天两组比较差异有显著统计学意义(P<0.01)。死亡组与存活组治疗后第5、7天与基础值比较,第7天与第3、5天比较差异有统计学意义(P<0.05)。存活组患者第7天与第3天比较差异有显著统计学意义(P<0.01)。死亡组患者APACHEⅡ评分随住院天数延长而增高,存活组则随住院天数延长而降低。PaO2/F iO2:死亡组与存活组治疗第3、5、7天两组比较差异均有显著统计学意义(P<0.01)。死亡组治疗后第5天PaO2/F iO2与基础值比较差异有显著统计学意义(P<0.01),而存活组患者则无明显改变。结论动态观察ARDS患者APACHEⅡ评分及氧合指数变化,有助于判断患者临床预后。Objective To discuss the effects of APACHEⅡscore and the oxygenation index（PaO2/FiO2） on the prognosis of the acute respiratory distress syndrome（ARDS）.Methods 30 cases of ARDS patients admitted in the Department of Respiratory Intensive Care Unit（RICU） of the General Hospital of Shenyang Military Region were collected and analyzed.According to the clinical prognosis,the patients were divided into death and survival group in which the impact of APACHE Ⅱ score and PaO2/FiO2 on the clinical prognosis was compared.Results 20 cases of ARDS patients died,10 cases survived.There are no significant difference（P〉0.05） between the death group and survival group in APACHE Ⅱ score,PaO2/FiO2 baseline value（when diagnosed）.APACHE Ⅱ score：The differences of the score between the death group and the survival group in day 5 and day 7 after treatment are very significant（P〈0.01）.The difference were also significant when compared day 5,day 7 with basaline level and day 7 with day 3,day 5 after treatment（P〈0.05）.The score of day 7 in survival group is significantly different to day 3（P〈0.01）.APACHE Ⅱ score in death group increased together with the duration of hospitalization and on the contrary,the score in survival group lowered together with the duration of hospitalization.PaO2/FiO2： The differences are very significant in day 3,day5,day7 between the death group and the survival group（P〈0.01）.And there are also very significant differences compared with basaline value on the 5th day in the death group（P〈0.01）,and no differences are found in the survival group.Conclusion Dynamic observation of CRP,APACHE Ⅱ score,PaO2/FiO2,ALB,Bun and other changes will help to predict the clinical prognosis and to direct the treatment.

关 键 词：ARDS APACHEⅡ评分 氧合指数 预后 

分 类 号：R563.8[医药卫生—呼吸系统]