摘要
目的探讨急性心理学与慢性健康状况(APACHE Ⅱ)评分系统对心脏大血管外科术后患者病情与预后的影响。方法选取2016年5月至2017年3月我院收治的131例心脏大血管手术患者为研究对象,在所有患者进入重症监护室24 h内评估其APACHE Ⅱ评分,评分的灵敏性和特异性以及各分值段的病死率。结果不同转归患者的APACHE Ⅱ评分相比,差异有统计学意义(P<0.05);不同术前心功能分级患者间的APACHE Ⅱ评分相比,差异有统计学意义(P<0.05),且心功能级数越高,APACHE Ⅱ评分相对越高。APACHE Ⅱ评分预测患者病死率为6.87%,APACHE Ⅱ评分的ROC曲线下面积为0.990,可信区间为0.984~0.996,表明其效能较好;以死亡概率>30%为预测标准,APACHE Ⅱ评分对死亡危险度预测的灵敏度、特异性分别为83.33%,96.80%;将APACHE Ⅱ得分按>20分、10~20分、<10分进行分组,仅>20分组预测的病死率在实际病死率95%可信区间内。结论APACHE Ⅱ评分在心脏大血管外科术后患者病情与预后中评估价值较高,可为临床进行分级监测干预提供参考依据,值得应用。
Objective To investigate the effects of acute psychology and chronic health status(APACHE Ⅱ)scoring system on the condition and prognosis of postoperation patients who underwent cardiac major vascular surgery.Methods We selected 131 cases of patients undergoing cardiac major vascular surgery admitted to our hospital from May 2016 to March 2017as a study object.The APACHE Ⅱ scores were assessed within 24 h of all patients entering the intensive care unit.The sensitivity and specificity of the scores were observed.And the mortality rate of each score segment was also observed.Results There was a statistically significant difference in APACHE Ⅱ scores between patients with different outcomes(P<0.05).The difference in APACHE Ⅱ scores between patients with different preoperative cardiac function classification was statistically significant(P<0.05),and the cardiac function grade was higher,the APACHE Ⅱ score was relatively higher.The APACHE Ⅱ score predicted that patient had mortality rate of 6.87%,the APACHE Ⅱ score had an area under the ROC curve of 0.990,and the confidence interval was 0.984 to 0.996,which indicated a good performance;with a probability of death>30%as the projection standards,The sensitivity and specificity of death risk prediction were 83.33%%and 96.80%respectively in APACHE Ⅱ score.The APACHE Ⅱ scores were grouped by>20 points,10-20 points,and<10 points.The mortality rate predicted by only>20 group was 95%confidence interval.Conclusion The APACHE Ⅱ score was worthy of evaluation in the condition and prognosis of patients after cardiac vascular surgery.It could provide reference for clinical grading monitoring intervention and was worthy of application.
作者
刘莹
杨向亚
李宇春
LIU Ying;YANG Xiang-ya;LI Yu-chun
出处
《护理实践与研究》
2019年第16期78-80,共3页
Nursing Practice and Research
