摘要
目的研究床旁肺脏超声联合急性生理及慢性健康评分系统(APACHEⅡ)在ICU老年急性呼吸窘迫综合症(ARDS)患者病情评估及预后判断中的价值。方法选取2017年10月—2021年2月于安徽医科大学附属安庆第一人民医院收治的68例老年ARDS患者作为观察组,另选同期30例无呼吸系统疾病的普通老年患者作为对照组,对照组接受APACHEⅡ评分评估,观察组在对照组基础上接受床旁肺脏超声检查,比较不同病情及预后结局的ARDS患者和对照组的床旁肺脏超声评分与APACHEⅡ评分,采用ROC曲线分析床旁肺脏超声联合APACHEⅡ评分对ARDS病情及预后的评估价值,采用spearman分析肺脏超声评分和APACHEⅡ评分的相关性。结果观察组的APACHEⅡ评分均高于对照组;重度组的肺脏超声评分、APACHEⅡ评分高于轻中度组(P<0.05);死亡组的肺脏超声评分、APACHEⅡ评分均高于存活组(P<0.05);肺脏超声联合APACHEⅡ评分诊断轻中、重度ARDS的AUC为0.887(95%CI:0.795~0.955),且联合诊断的AUC高于单一诊断(P<0.05);肺脏超声联合APACHEⅡ评分评估ARDS患者预后的AUC为0.876(95%CI:0.774~0.944),且联合评估的AUC高于单一评估(P<0.05);ARDS患者的肺脏超声评分与APACHEⅡ评分呈正相关(r=0.705,P=0.003)。结论床旁肺脏超声联合APACHEⅡ评分可有效地评估ARDS患者病情和预后。
Objective To study the value of bedside lung ultrasound combined with Acute Physiology and Chronic Health Scoring System(APACHEⅡ)in the evaluation of the condition and prognosis of elderly patients with acute respiratory distress syndrome(ARDS)in ICU.Methods 68 elderly patients with ARDS treated in Anqing First People’s Hospital Affiliated to Anhui Medical University from October 2017 to February 2021 were selected as the case group.Another 30 ordinary elderly patients without respiratory diseases during the same period were selected as the control group.The control group was evaluated with APACHEⅡ,and the case group received bedside lung ultrasonography on the basis of the control group.The APACHEⅡscore were compared between the two groups.The scores of bedside lung ultrasound and APACHEⅡwere compared among ARDS patients with different disease conditions and prognostic outcomes.The ROC curve was used to analyze the value of bedside lung ultrasound combined with APACHE II score in the evaluation of the condition and prognosis of ARDS.Spearman correlation analysis was used to analyze the correlation between lung ultrasound score and APACHEⅡscore.Results The score of APACHEⅡof the case group was higher than that of control group.The scores of bedside lung ultrasound and APACHEⅡof the severe group were higher than those of the mild-moderate group(P<0.05).The scores of bedside lung ultrasound and APACHEⅡof the death group were higher than those of the survival group(P<0.05).The AUC of lung ultrasound combined with APACHEⅡscore in the diagnosis of mild-moderate and severe ARDS was 0.887(95%CI:0.795-0.955),and the AUC of combined diagnosis was higher than that of single diagnosis(P<0.05).The AUC of lung ultrasound combined with APACHEⅡscore in the evaluation of the prognosis of ARDS patients was 0.876(95%CI:0.774-0.944),and the AUC of the combined evaluation was greater than that of single evaluation(P<0.05).The lung ultrasound score of ARDS patients was positively correlated with their APACHEⅡs
作者
荣清源
杨晓帆
李艳平
谢娟
Rong Qingyuan;Yang Xiaofan;Li Yanping;Xie Juan(Department of Critical Care Medicine,Anqing First People's Hospital Affiliated to Anhui Medical University.Anqing,Anhui,246000,P.R.China;Department of Ultrasound,Anqing First People's Hospital Affiliated to Anhui Medical University.Anqing,Anhui,246000,P.R.China)
出处
《老年医学与保健》
CAS
2021年第6期1314-1318,共5页
Geriatrics & Health Care
关键词
老年
床旁肺脏超声
急性生理及慢性健康评分系统
急性呼吸窘迫
预后
elderly
bedside lung ultrasound
Acute Physiology and chronic Health Scoring System
acute respiratory distress syndrome
prognosis
