改良APACHEⅡ评分结合早期动脉血乳酸清除率评估产后脓毒症死亡风险的价值  

Value of modified APACHEⅡscore combined with early arterial blood lactate clearance rate to assess risk of death in postpartum sepsis

作　　者：侯祎珺 翟俊英[1] 钮红丽[1] HOU Yijun;ZHAI Junying;NIU Hongli(Department of Reproductive Medicine,Nanyang First People's Hospital,Nanyang 473000,China)

机构地区：[1]南阳市第一人民医院生殖医学科,河南南阳473000

出　　处：《中国医学工程》2023年第1期74-77,共4页China Medical Engineering

摘　　要：目的分析改良急性生理学与慢性健康状况Ⅱ(APACHEⅡ)评分结合早期动脉血乳酸清除率(LCR)对产后脓毒症死亡风险的评估价值。方法回顾性分析2014年1月至2020年8月南阳市第一人民医院收治的91例产后脓毒症患者的临床资料,均采用改良APACHEⅡ评分评价,均计算入院6 h动脉LCR。统计死亡率;对比死亡和存活患者改良APACHEⅡ评分和入院6 h动脉LCR;以受试者工作特征(ROC)曲线分析二者结合对死亡风险的评估价值。结果所选患者死亡率为34.07%;死亡患者改良APACHEⅡ评分高于存活患者,入院6 h动脉LCR低于存活患者,对比差异均有统计学意义(P<0.05);改良APACHEⅡ评分、早期动脉LCR评估产后脓毒症死亡的Cut-off值分别为28分、18.71%,二者结合评估危重症孕产妇死亡的特异度、AUC分别为91.67%、0.917,均高于单独评估,灵敏度为100.00%,与单独评估相当。结论改良APACHEⅡ评分结合早期动脉LCR对产后脓毒症死亡风险有较高的评估价值。【Objective】To analyze the value of modified acute physiology and chronic health evaluationⅡ(APACHEⅡ)score combined with early arterial blood lactate clearance(LCR)in the evaluation of the risk of postpartum sepsis death.【Methods】The clinical data of 91 cases of postpartum sepsis were analyzed retrospectively.All of them were evaluated by modified APACHEⅡscore,and LCR of arteries was calculated at 6 hour after admission.The mortality was counted,and the improved APACHEⅡscores and LCR were compared between the dead and the surviving patients.The evaluation value of the combination of modified APACHEⅡscore and early LCR on the risk of death by receiver operating characteristic(ROC)curve.【Results】The mortality rate was 34.07%.The modified APACHEⅡscore of the dead patients was higher than that of the surviving patients,and the LCR of the arteries was lower than that of the surviving patients,with statistically significant differences(P<0.05).The Cut-off values of modified APACHEⅡscore and early arterial LCR were 28 and 18.71%respectively,and the specificity and AUC of the combination of two methods were 91.67%and 0.917 respectively,which were higher than those of single evaluation,and the sensitivity was 100.00%,which was similar to that of single evaluation.【Conclusion】The modified APACHEⅡscore combined with early arterial LCR has a high value in assessing the risk of death from postpartum sepsis.

关 键 词：急性生理学与慢性健康状况Ⅱ评分 动脉血乳酸清除率 脓毒症 死亡风险 

分 类 号：R714[医药卫生—妇产科学]