APACHEⅡ和SOFA评分在蜂蜇伤并发MODS患者预后评价中的应用及其对护理的指导  

Prognosis of Patients with Wasp Sting Complicated with Multiple Organ Dysfunction Syndrome Stratified with APACHE Ⅱ and SOFA and Its Guidance to Nursing

作　　者：雍郑蓉[1] 徐朝霞[1] 李洁[1] 周敏[1] 尹昌林[2] 周人杰[3] 

机构地区：[1]中国人民解放军成都军区总医院急诊科,四川成都610083 [2]第三军医大学西南医院急救部,重庆400038 [3]第三军医大学新桥医院急救部,重庆400037

出　　处：《护理学报》2011年第17期55-58,共4页Journal of Nursing（China）

基　　金：四川省卫生厅资助项目(100189)

摘　　要：目的探讨急性生理学及慢性健康状况评分Ⅱ(Acute Physiology and Chronic Health EvaluationⅡ,APACHEⅡ)和序贯器官衰竭估计(Sequential Organ Failure Assessment,SOFA)对连续性静脉-静脉血液滤过联合血液灌流治疗蜂蜇伤并发多器官功能障碍综合征患者预后评价的价值。方法回顾性分析3所医院2006年1月—2010年12月行连续性静脉-静脉血液滤过联合血液灌流治疗的32例蜂蜇伤并发多器官功能障碍综合征患者,按治疗转归分为死亡组和存活组,对比分析两组治疗前和治疗24 h后的APACHEⅡ评分、SOFA评分。结果 (1)死亡组治疗前后APACHEⅡ和SOFA评分始终明显高于存活组(P<0.01)。(2)存活组治疗24 h后APACHEⅡ和SOFA评分显著降低(P<0.01),死亡组变化无统计学意义(P>0.05)。结论 APACHEⅡ和SOFA评分对判断连续性静脉-静脉血液滤过联合血液灌流治疗蜂蜇伤并发多器官功能障碍综合征的治疗时机及预后有指导意义,对护理工作也起着指导作用。Objective To explore the prognosis of patients with wasp sting complicated with multiple organ dysfunction syndrome（MODS） using continuous veno-venous hemofiltration（CVVH） combined with hemoperfusion（HP） stratified with Acute Physiology and Chronic Health Evaluation Ⅱ（APACHE Ⅱ） and Sequential Organ Failure Assessment（SOFA）.Methods With retrospective study,32 patients with wasp sting complicated with MODS treated with CVVH combined with HP in the period of January 2006 to December 2010 were divided into survival group and non-survival group.Their scores of APACHE Ⅱ and SOFA were compared before and after CVVH combined with HP 24 h later.Results The scores of APACHE Ⅱ and SOFA were always higher in non-survival group than those in survival group before and 24 h after CVVH combined with HP（P0.01）.The scores of APACHE Ⅱ and SOFA decreased significantly in survival group（P0.01）,but insignificantly in non-survival group（P0.05）.Conclusion APACHE Ⅱ and SOFA are useful for treatment opportunity and the prognosis of patients with wasp sting complicated with MODS using CVVH combined with HP.The results of APACHE Ⅱ and SOFA indicate remarkable significance to guide nursing care.

关 键 词：蜂蜇伤 多器官功能障碍综合征 连续性静脉-静脉血液滤过 血液灌流 急性生理学及慢性健康状况评分Ⅱ 序贯器官衰竭估计 护理 

分 类 号：R473.59[医药卫生—护理学]