APACHEⅡ评分对AECOPD伴机械通气患者预后的预测价值

摘要

Aim To explore the value of APACHE Ⅱ in prognostic assessment of patients with AECOPD combined with mechanical ventilation. Methods 98 cases of AECOPD combined with mechanical ventilation from January 2005 to August 2010 were admitted.retrospective and statistical analyses of the data from all cases were performed. Results APACHE Ⅱ scores. duration of IPPV and duration of hospitalization of died group and survival group were 23. 91 ±7. 34 , 18. 43 ±5. 51 ; 18. 04± 19. 69 ,4. 58 ± 4. 41 ; 25. 37 ± 22. 98 . 10. 98 ± 19. 14 respectively. There were significant differences in two groups( P ＜ 0. 05 ). The mortality was up as the APACHE Ⅱ increased.The mortality increased remarkably when the score was more than 20. Conclusion APACHE Ⅱ was effective to evaluate the severity of patients, which was limited to predict mortality.%目的 探讨急性生理学与慢性健康状况评分Ⅱ(APACHEⅡ)在慢性阻塞性肺疾病急性加重期(AECOPD)伴机械通气患者预后预测中的应用价值.方法 回顾性的分析我科2005年1月至2010年8月收治的98例AECOPD伴机械通气患者的临床资料,计算APACHEⅡ和死亡风险,然后进行统计学处理与分析.结果 死亡组和好转组APACHEⅡ评分、有创通气时间(d)、住ICU时间(d)分别为23.91±7.34、18.43±5.51;18.04±19.69、4.58±4.41;25.37±22.98、10.98±19.14,组间差异均有显著性(P均＜0.05).APACHEⅡ评分ROC曲线下面积分别是0.719(P=0.001).随着APACHEⅡ评分的增加,死亡率也逐步增加,当APACHEⅡ评分超过20分时死亡率增加明显.APACHEⅡ对患者死亡风险的预测效果偏差.结论 APACHEⅡ评分对AECOPD伴呼吸衰竭患者病情的评估有一定的效果,但在预测患者死亡率方面价值有限.