ICU脓毒性休克患者24 h内APACHEⅡ和SOFA评分状况及其预后分析  

Analysis of APACHEⅡand SOFA scores and prognosis in ICU septic shock patients

作　　者：朱云青 徐敏荣 许秀娟[1] ZHU Yunqing;XU Minrong;XU Xiujuan(Deparment of ICU,Zhejiang Provincial Tongde Hospital,Hanghzou 310012,China)

机构地区：[1]浙江省立同德医院ICU,浙江杭州310012

出　　处：《中国现代医生》2022年第18期116-119,共4页China Modern Doctor

基　　金：浙江省医药卫生科技计划项目(2021KY606)。

摘　　要：目的探讨重症监护室(ICU)脓毒性休克患者24 h内急性生理和慢性健康状况评分(APACHEⅡ)和序贯器官衰竭(SOFA)评分状况及其预后。方法回顾性分析浙江省立同德医院2019年6月~2020年10月期间接诊的90例ICU脓毒性休克患者作为研究对象。根据患者的预后情况,将其分为存活组60例和死亡组30例。记录并比较两组患者在入院时与入院30 d内APACHEⅡ和SOFA评分。结果肺部、血液、泌尿、腹腔不同病灶部位患者的APACHEⅡ评分分别为(20.16±2.06)分、(19.98±4.26)分、(20.45±1.12)分、(20.67±1.16)分,肺部、血液、泌尿、腹腔不同病灶部位患者的SOFA评分分别为(7.93±0.32)分、(7.88±0.64)分、(8.12±1.06)分、(8.24±1.15)分,不同病灶部位患者的APACHEⅡ评分、SOFA评分相比,差异均无统计学意义(均P>0.05)。存活组患者在入院第5天的APACHEⅡ评分、SOFA评分分别为(28.43±0.65)分、(8.93±0.24)分,死亡组患者在入院第5天的APACHEⅡ评分、SOFA评分分别为(28.65±0.46)分、(9.01±0.19)分,两组相比,差异均无统计学意义(均P>0.05);存活组患者在入院第10天的APACHEⅡ评分、SOFA评分分别为(22.16±0.58)分、(5.36±0.18)分,死亡组患者在入院第10天的APACHEⅡ评分、SOFA评分分别为(25.14±0.39)分、(7.62±0.05)分,入院第10天两组患者的APACHEⅡ评分、SOFA评分均明显降低,且存活组显著低于死亡组,差异有统计学意义(均P<0.05)。采用Logistic回归性分析发现,年龄、APACHEⅡ评分、SOFA评分均是影响脓毒症患者预后的危险因素(均P<0.05)。结论患者的APACHEⅡ评分、SOFA评分对ICU脓毒性休克患者均有一定的预后评估价值,多指标联合的评估价值更高些,具有临床应用价值,值得推广。Objective To explore the acute physiology and chronic health score(APACHEⅡ)and sequential organ failure(SOFA)of septic shock patients in intensive care unit(ICU)within 24 hours and their prognosis.Methods A total of 90 patients with septic shock in Zhejiang Provincial Tongde Hospital from June 2019 to October 2020 were retrospectively analyzed.according to the prognosis,the patients were divided into survival group and death group,60 cases in survival group and 30 cases in death group.the heart rate,body temperature,APACHEⅡand SOFA scores in 24 hours were recorded and compared between the two groups.Results The APACHEⅡscores of patients with lung,blood,urinary and abdominal lesions were(20.16±2.06)points,(19.98±4.26)points,(20.45±1.12)points,(20.67±1.16)points,the SOFA scores of lung,blood,urinary and abdominal lesions were(7.93±0.32)points,(7.88±0.64)points,(8.12±1.06)points,(8.24±1.15)points,there was no significant difference in APACHEⅡscore and SOFA score among patients with different lesion sites(all P>0.05).The APACHEⅡscore and SOFA score of survival group patients on the 5th day of admission were(28.43±0.65)points,(8.93±0.24)points,the results showed that the scores of APACHEⅡand SOFA were(28.65±0.46)points,(9.01±0.19)points,on the 5th day of admission,there was no significant difference between the two groups(all P>0.05).the APACHEⅡscore and SOFA score of survival group were(22.16±0.58)points,(5.36±0.18)points,on the 10th day of admission,the scores of APACHEⅡand SOFA were(25.14±0.39)points,(7.62±0.05)points,on the 10th day of admission in the death group,the scores of APACHEⅡand SOFA were significantly lower in the two groups on the 10th day of admission,and the survival group was significantly lower than that of the death group(P<0.05).Logistic regression analysis showed that age,APACHEⅡscore and SOFA score were risk factors for the prognosis of patients with sepsis(all P<0.05).Conclusion APACHEⅡscore and SOFA score have certain prognostic value for ICU patients wit

关 键 词：脓毒性休克 急性生理和慢性健康状况评分 序贯器官衰竭 预后 

分 类 号：R631[医药卫生—外科学]