应用不同疾病严重程度评分系统进行ICU护理分级的可行性研究  

Feasibility study on application of different disease severity scoring systems in classifying nursing grading of patients in ICU

作　　者：石青青 范宇莹[1] 张悦 王宇 王晓慧 常广明 SHI Qingqing;FAN Yuying;ZHANG Yue;WANG Yu;WANG Xiaohui;CHANG Guangming(School of Nursing,Harbin Medical University,Heilongjiang 150000 China)

机构地区：[1]哈尔滨医科大学护理学院,黑龙江150000 [2]哈尔滨医科大学附属第二医院

出　　处：《护理研究》2020年第9期1506-1510,共5页Chinese Nursing Research

基　　金：国家自然科学基金,编号:71704040。

摘　　要：[目的]探讨采用急性生理和慢性健康评价系统Ⅱ(APACHEⅡ)、简化急性生理评分2(SAPS2)、病死概率模型Ⅱ(MPMⅡ)3种常用的疾病严重程度评分系统对重症监护室(ICU)病人进行护理分级的可行性。[方法]选取某三级甲等医院在ICU接受监护的病人300例,应用APACHEⅡ、SAPS2、MPMⅡ3种疾病严重程度评分系统进行横断面调查,以"ICU重症病人ABCD护理分级管理方法"作为校标,应用ROC曲线下面积比较这3种评分系统对ICU病人进行护理分级的效果。[结果]APACHEⅡ、SAPS2、MPMⅡ3种评分系统与ICU重症病人ABCD护理分级均呈正相关(P<0.01);SAPS2对A级病人的分辨能力(AUC=0.698)略高于APACHEⅡ(AUC=0.639)、MPMⅡ(AUC=0.651);3种评分系统对A级+B级病人的分辨能力高于对A级病人的分辨能力(P<0.001),而MPMⅡ对A级+B级病人的分辨能力(AUC=0.735)优于APACHEⅡ(AUC=0.695)、SAPS2(AUC=0.695)。[结论]APACHEⅡ、SAPS2、MPMⅡ3种评分系统与ICU重症病人ABCD护理分级均相关,应用SAPS2、MPMⅡ区分ICU病人护理分级效果较好。Objective:To explore the feasibility of using APACHEⅡ,SAPS2,MPMⅡthree commonly used disease severity scoring systems to classify the nursing grading of ICU patients.Methods:A cross-sectional study was conducted on 300 ICU patients in a tertiary hospital.APACHEⅡ,SAPS2 and MPMⅡdisease severity scoring systems were used to assess the severity of ICU patients.The"ABCD nursing classification management method for ICU patients"was used as the criterion to correlate the validity and the ROC curve was used to compare the effect of nursing grade of three scoring systems in ICU patients.Results:APACHEⅡ,SAPS2 and MPMⅡwere positively correlated with the ABCD nursing classsification of ICU patients(P<0.01).The ability of SAPS2 to distinguish patients of grade A(AUC=0.698)was slightly higher than that of APACHEⅡ(AUC=0.639)and MPMⅡ(AUC=0.651).The distinction ability of three scoring systems for A+B patients were higher than that of A patients(P<0.001),while the distinction ability of MPMⅡfor A+B patients(AUC=0.735)was better than those of APACHEⅡ(AUC=0.695)and SAPS2(AUC=0.695).Conclusion:The three scoring systems,APACHEEⅡ,SAPS2 and MPMⅡwere all correlated with the ABCD nursing classification of ICU patients.Among them,SAPS2 and MPMⅡhad good effect in classifying the nursing grading of ICU patients.

关 键 词：急性生理和慢性健康评价系统 简化急性生理评分 病死概率模型 疾病严重程度 评分系统 重症监护室 护理分级 

分 类 号：R197.323[医药卫生—卫生事业管理]