急性生理学与慢性健康状况评分系统Ⅱ和营养风险筛查-2002在危重症患者中的应用  

Relationship between APACHE Ⅱ and nutrition risk screening-2002 in severe patients

作　　者：安志红[1] 王殿华[1] 朱健 吴晓棣 张静[1] 许家俊[1] 

机构地区：[1]上海市第二人民医院ICU,上海200011 [2]上海市第九人民医院急诊科

出　　处：《中国临床保健杂志》2014年第6期570-573,I0007,共5页Chinese Journal of Clinical Healthcare

基　　金：上海市卫生局资助项目(20114332)

摘　　要：目的：探讨危重症患者中急性生理学与慢性健康状况评分系统Ⅱ（APACHEⅡ）与营养风险筛查-2002（NRS-2002）的关系。方法选择重症监护病房（ICU）的128例危重症患者，按下列分组：组 A （APACHEⅡ＜18分）34例、组 B（18分≤APACHEⅡ≤25分）63例、组 C（APACHEⅡ＞25分）31例；Ⅰ组（NRS-2002分值在0～4分）28例、Ⅱ组（NRS-2002分值在5～6分）68例、Ⅲ组（NRS-2002分值7分）32例，分别比较下列指标：住院天数、住院总费用、日均住院费用、并发症数、并发症发生率、病死率在各组间的差异，并分析 APACHEⅡ与 NRS-2002的相关性。结果在 A ／B／C 分组中，随着 APACHEⅡ分值的增加，日均住院费用、并发症数、病死率、NRS-2002分值等指标升高明显（P ＜0．05）；在Ⅰ／Ⅱ／Ⅲ分组中，随 NRS-2002分值增加，APACHEⅡ分值、日均住院费用、住院总费用、并发症数、并发症发生率等指标增加显著（P ＜0．05）。APACHEⅡ分值与 NRS-2002分值呈正相关（r ＝0．509，P ＝0．000）。结论APACHEⅡ与 NRS-2002均有助于判断危重症患者的病情及预后，两者相结合，可以更好指导临床医师对患者进行病情评估及预后判断。Objective To explore the relationship between acute physiology and chronic health evaluation Ⅱand nutrition risk screening -2002 among severe patients.Method A total of 1 28 severe patients were chosen in in-tensive care unit（ICU）of our hospital from May 201 1 to October 201 2.The patients were divided into six groups：group A（n =34,APACHEⅡ score 〈1 8）,group B（n =63,APACHEⅡ score ranged from 1 8 to 25）,group C（n =31 ,APACHEⅡ score 〉25）,groupⅠ（n =28,NRS-2002 score ranged from 0 to 4）,groupⅡ（n =68,NRS-2002 score ranged from 5 to 6）,group Ⅲ（n =32,NRS-2002 score is 7）.The duration of hospitalization,total expenses,daily ex- penses,incidence rate of complications,mortality rate were compared among these groups.Then,the interrelationship between APACHE Ⅱ and NRS-2002 was also analyzed.Results Among the A,B and C groups,the duration of hos-pitalization,total expenses,daily expenses,incidence rate of complications,mortality rate,and NRS-2002 score were increased （P 〈0.05）with the increase of APACHEⅡ score.the duration of hospitalization,total expenses,daily ex-penses,incidence rate of complications,mortality rate,and APACHE Ⅱ score were also increased （P 〈0.05）with the increase of NRS-2002 score among theⅠ,Ⅱ and Ⅲ groups.The APACHEⅡand NRS-2002 were positively corre-lated （r =0.509,P =0.000）.Conclusion The APACHEⅡ and NRS-2002 are helpful to estimate the severity and prognosis of severe patients.Even more,the combination of these two scores system may be more meaningful.

关 键 词：急性病生理学和长期健康评价 营养调查 危重 病人医疗 

分 类 号：R459.7[医药卫生—急诊医学]