APACHEⅢSAPSⅡ与APACHEⅡ评分系统对急诊内科危重患者病情评估的临床意义  

The clinical significance of APACHEⅢ SAPSⅡ and APACHEⅡ scoring systems for severe patients in emergency department

作　　者：许榕椿[1] 翁志成[1] 

机构地区：[1]福建医科大学附属协和医院,福建福州350001

出　　处：《济宁医学院学报》2009年第6期403-405,共3页Journal of Jining Medical University

摘　　要：目的比较和评价急性生理学与慢性健康状况评分系统Ⅲ(APACHEⅢ)、简明急性生理功能评分系统Ⅱ(SAPSⅡ)、急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)在急诊内科危重病人病情和预后以及其之间差异。方法收集211例急诊内科危重病人的病例资料并分别用《危重疾病评分系统》中进行A-PACHEⅢ、SAPSⅡ与APACHEⅡ评分,计算SAPSⅡ、APACHEⅡ与APACHEⅢ的分值并预计病死率,比较生存组与死亡组之间各种评分分值和预计病死率的差异;同时比较APACHEⅢ、SAPSⅡ与APACHEⅡ分辨度的差异。结果3种病情评价系统的评分分值和预计病死率在生存组与死亡组之间差异有统计学意义(P<0.05)。APACHEⅢ、SAPSⅡ与APACHEⅡ的AUROCC分别为0.868、0.851和0.857,均>0.850,相互比较差异均无统计学意义(P>0.05)。结论各种病情评价系统可用于评价急诊内科危重病人的病情严重程度,3种病情评价系统相互配合可较好地评价危重疾病的严重程度,预测预后。Objective To compare and evaluate the prognostic value of three prognostic systems namely acute physiology and chronic health evaluation Ⅲ（APACHE Ⅲ） simplified acute physiology score Ⅱ（SAPS Ⅱ）,and acute physiology and chronic health evaluation Ⅱ（APACHE Ⅱ）.on intensive patients in emergency department by means of statistical analysis.Methods Data of 211 patients were collected at admission.APACHEⅢ、SAPSⅡ score and APACHEⅡscore were calculated in 24 hours.To analyze mortality of patients in different score,to estimate dependability of them,The difference were compared between PHMs of APACHEⅢ,SAPSⅡ,APACHEⅡand actual mortality of all patients.The discriminations were compare among APACHEⅢ,SAPSⅡand APACHEⅡ.Results There have significantly difference between survivor group for scoring values and PHMs of all three evaluating systems（P〈0.05）.There have no significantly difference among APACHEⅢ（0.868）,SAPSⅡ（0.851）and APACHEⅡ（0.857） for AUROCCs.Conclusion All three evaluating systems can be used to evaluate the severity of emergency intemal intensive patients.

关 键 词：危重病 急性生理学 慢性健康状况 评分 

分 类 号：R459.7[医药卫生—急诊医学]