摘要
目的探讨急诊重症监护病房(EICU)心肺复苏(cardiopulmonary resuscitation,CPR)术后患者急性生理学与慢性健康状况评价系统Ⅱ(acute physiology and chronichealth evaluation,APACHEⅡ)评分变化与预后的相关性。方法选择2010年1月—2012年12月我院EICU实施CPR术后自主循环恢复(ROSC)患者58例,按存活时间分为存活≤24 h组(31例)和存活>24 h组(27例),再根据患者最终存活情况,将存活>24 h组又分为成活出院组(13例)和死亡组(14例),比较各组ROSC后1、6 h APACHEⅡ评分,两次APACHEⅡ评分差值及评分变化率。结果存活≤24 h组和存活>24 h组ROSC后1、6 h APACHEⅡ评分比较差异无统计学意义(t=0.711,P=0.480;t=1.124,P=0.266),但两组APACHEⅡ评分差值和评分变化率比较差异均有统计学意义(t=2.991,P=0.004;t=3.938,P=0.000);两组ROSC后1、6 h评分变化率与1 h评分值无明显相关性(r=0.015,P=0.913)。成活出院组和死亡组ROSC后1 h APACHEⅡ评分比较差异无统计学意义(t=1.867,P>0.05),但6 h评分比较差异有统计学意义(t=7.024,P<0.01);两次APACHEⅡ评分差值及评分变化率比较差异均有统计学意义(t=4.151,P<0.01;t=7.334,P<0.01)。结论对于EICU实施CPR术后患者,APACHEⅡ评分变化率能更早期、更准确地预测患者预后。
Objective To explore the correlation between the changes of acute physiology and chronic health evalua-tion II （APACHE II） score and the prognoses of post-cardiopulmonary resuscitation （CPR） patients in emergency intensive care unit （EICU）. Methods A total of 58 post-CPR patients with restoration of spontaneous circulation （ ROSC） in the EICU between January 2010 and December 2012 were divided into not longer than 24 h group （group A, n = 31） and longer than 24 h （group B, n = 27） according to survival time, and the group B was further divided into the discharged subgroup （n = 13） and the death subgroup （n = 14）. The APACHEII scores 1 h and 6 h after ROSC in all groups, different values and change rates of APACHE Ⅱ scores were compared. Results The differences of APACHE II scores 1 h and 6 h after ROSC in group A and B were not statistically significant （t = 0. 711, P = 0. 480; t = 1. 124, P = 0. 266）, but the differences of differ-ent values and change rates of APACHE Ⅱ scores in the two groups were statistically significant （t = 2. 991, P = 0. 004; t =3. 938, P = 0. 000）; there was no correlation between the change rate of 1 h and 6 h after ROSC with 1 h after ROSC score （r = 0. 015, P = 0. 913）. The difference of APACHE II scores 1 h after ROSC in the two subgroups was not statistically signif-icant （t = 1. 867, P 〉0. 05）, however the difference of APACHE II scores 6 h after ROSC in the two subgroups was signifi-cant （t = 7. 024, P 〈 0. 01）; the differences in different values and change rates of APACHE Ⅱ scores in the two subgroups were also statistically significant （ t = 4. 151, P 〈 0. 01; t = 7. 334, P 〈 0. 01）. Conclusion The change rate of the APACHE Ⅱ score is an earlier and better prognosis prediction index for the post-CPR patients in EICU.
出处
《临床误诊误治》
2014年第7期7-10,共4页
Clinical Misdiagnosis & Mistherapy
基金
海南省自然科学基金(812150)
