APACHEⅡ评分联合乳酸评估脓毒症在ICU出科时间的应用价值  

Application value of APACHEⅡscore combined with lactic acid in evaluating the time costed in ICU of patients with sepsis

作　　者：肖百芳[1] 张亚娟[1] 王笑云[1] 肖岳 XIAO Bai-fang(Department of critical care medicine,Meizhou people's hospital,Meizhou,Guangdong,514031,China)

机构地区：[1]梅州市人民医院重症医学二科,广东梅州514031

出　　处：《齐齐哈尔医学院学报》2020年第10期1232-1234,共3页Journal of Qiqihar Medical University

摘　　要：目的探究脓毒症在ICU出科时间的影响因素及急性生理与慢性健康评分(APACHEⅡ)评估脓毒症出科时间的应用价值。方法选取2018年6月—2019年6月本院收治的137例脓毒症患者进行回顾性分析,根据住ICU时间分为两组,1组住ICU时间为≤72小时48例,2组住ICU时间为>72小时89例,比较两组基础资料包括年龄、性别、基础疾病、感染部位,治疗检查资料包括APACHEII评分、6小时液体复苏量、治疗前后乳酸、降钙素原(PCT)、白细胞、病原学检查结果、平均动脉压等指标的差异,应用二元Logistic分析影响出科时间的因素,应用受试者工作特征(ROC)曲线分析影响因素对出科时间的评估效果。结果比较两组患者的年龄、性别、基础疾病等临床基础资料,差异无统计学意义(P>0.05);两组间感染部位、APACHEⅡ评分及病原学检查差异具有统计学意义(P=0.00)。二元Logistic分析显示入院时平均动脉压、APACHEⅡ评分是出科时间的影响因素;APACHEⅡ评分、入院乳酸联合预测脓毒症出科时间的AUC为0.93(P<0.05)。结论 APACHEII评分联合乳酸作为脓毒症患者疾病出科时间具有一定的临床意义。Objective To explore the influencing factors and the application value of scores of Acute Physiology and Chronic Health Evaluation II(APACHEII) in evaluating the discharge time of patients sepsis.Methods 138 patients with sepsis admitted to our hospital from June 2017 to June 2019 were selected for the study and the data were retrospectively analyzed. According to the time spent in ICU, they were divided into two groups,the 48 patients whose hospitalization time in ICU equal or less than 72 hours were in group 1, and 89 patients whose time spent in ICU over 72 hours were on group 2. Comparison was carried out on base data of the two groups including age, gender,basic diseases, infections sites, treatment check data of APACHEⅡ scores, amount of fluid resuscitation after 6 hours, lactic acid before and after the treatment, procalcitonin(PCT), white blood cells, etiology examination results, mean arterial pressure etc. Binary Logistic analysis was used to analyze the factors influencing the discharge time, and the receiver operating characteristic(ROC) curve was used to analyze the evaluation effect of the binary logistic analysis.Results There were no significant difference in the basic clinical data including age,gender, basic diseases(P>0.05).There were statistically significant differences in the site of infection, APACHEⅡ score and pathogen examination(P=0.00).Binary Logistic analysis showed that mean arterial pressure at admission and APACHEⅡ score were the influencing factors of discharge time.The AUC of APACHEⅡcombined with lactic acid at admissionscore in predicting the discharge time of sepsis was 0.93(P<0.05).Conclusions The combination of APACHEⅡ score and lactic acid has certain clinical significance in predicting the time of discharge of sepsis patients.

关 键 词：脓毒症 危险因素 预后 

分 类 号：R459.7[医药卫生—急诊医学]