摘要
目的探讨APACHEⅡ评分结果与有创机械通气患者发生谵妄的相关性及预测发生谵妄的价值。方法选择2011年1月至2014年1月在我科接受有创机械通气患者为研究对象,采集每位患者入科最初24 h内APACHEⅡ评分结果;采用ICU谵妄诊断的意识状态评估法(CAM-ICU)进行谵妄评估,将患者分为谵妄组和非谵妄组,用统计学方法对两组患者APACHEⅡ评分结果进行比较、分析,以P<0.05为差异有统计学意义。绘出APACHEⅡ评分工作特征曲线(ROC曲线),计算ROC曲线下面积,计算出谵妄发生的预测指标。结果 50例患者分为谵妄组28例,非谵妄组22例,谵妄发生率56.0%;谵妄组APACHEⅡ评分(29.0±5.6)分,高于非谵妄组的(19.5±4.1)分,差异有统计学意义(P<0.05);APACHEⅡ评分的ROC曲线下面积为0.920,判断谵妄发生的最佳截点为≥21分,敏感性100.0%,特异性68.2%,阳性预测值80.0%,阴性预测值100.0%。结论 APACHEⅡ评分结果是机械通气患者谵妄发生的危险因素,对这类患者的谵妄有较高的预测价值,有方法简单、实用、可操作性强的优点。
Objective To study the correlation between APACHE II scores and the probability of patients who are receving invasive mechanical ventilation suffering delirium and the value of predicting delirium. Methods Chose patients receiving invasive mechanical ventilation from January 2011 to January 2014 in ICU for the study and coUected APACHE II scores of each patient within the first 24 hours. Using Consciousness Assessment Method-ICU （CAM-ICU） to diagnose delirium, divided patients into delirium group and non-delirium group, analyzed and compared APACHE II scores of this two groups with statistical methods when difference（P〈0.05） was statistically significant. Plot APACHE II scores characteristic curve （ROC curve）, calculated the area under this ROC curve and carried out predictive value of delirium occurring. Results 50 patients were divided into two groups： delirium group, 28 cases; non-delirium group, 22 cases, the incidence of delirium was 56.0%. APACHE II scores of delirium group （29.0±5.6） points, were higher than that of non-delirium group （19.5±4.1） points and the difference was statistically significance （P〈0.05）. The area under ROC curve of APACHE II scores was 0.920, and then we can determine that the best breaking point of delirium occuring was≥21 points with 100% sensitivity, 68.2% specificity, 80.0% positive predictive value and 100.0% negative predictive value. Conclusion APACHE Ⅱ scores are risk factors of patients who are receving mechanical ventilation suffering delirium. And APACHE Ⅱ scores have high predictive value for those patients. The method of prediction is simple, practical and operational.
出处
《中华临床医师杂志（电子版）》
CAS
2015年第8期58-61,共4页
Chinese Journal of Clinicians(Electronic Edition)
基金
南通市科技计划项目(HS12923)
