APACHEⅡ评分引入MODS评分系统对ICU危重症患者预后的预测价值

摘要

目的:研究APACHEⅡ评分对ICU危重症患者预后的预测及APACHEⅡ评分引入MODS评分系统对ICU危重症患者预后的预测价值.方法:将300名ICU患者分别进行APACHEⅡ评分和MODS评分并计算病死率.结果:运用APACHEⅡ评分及MODS评分得出的病死人数均分别高于存活人数,差异均具有统计学意义(P<0.05);运用APACHEⅡ评分对全体患者、无MODS组和MODS组患者进行预测,APACHEⅡ的得分随着患者病情的严重程度而增加,其中MODS组患者的APACHEⅡ得分最高,得分为24.25±6.09,各组间差异均具有统计学意义(P<0.05).研究中的实际病死率为26.67%,预计病死率为30.15%,差异无统计学意义(P>0.05).无MODS组患者的实际病死率为12.12%,低于预计病死率的18.67%,MODS组患者的实际病死率为75.36%,明显高于预计病死率的46.17%,两组间差异均具有统计学意义(P<0.05).结论:APACHEⅡ能够很好的预测疾病的病死率和危险程度,但对于合并MODS的患者的预测结果不是十分理想.将APACHEⅡ评分系统引入MODS评分系统,能提高预测的完整性和准确性,对于ICU危重症患者的治疗和监测具有良好的作用,能够有效的控制疾病的发展,降低疾病的病死率.%Objective:Predictive value of APACHEII score on prognosis of critically ill patients in ICU and APACHEII scoring system for predicting prognosis of critically ill patients in emergency internal medicine in MODS score.Methods: APACHEII score and MODS score of 300 critically ill patients in emergency internal medicine were calculated and the mortality was calculated.Results: T he use of the number of deaths of APACHEII score and MODS score were higher than the number of people living, the differences were statistically significant (P < 0.05);using the APACHEII score to predict all patients, MODS group and MODS group, APACHEII score increased with the severity of disease, the patients in the MODS group APACHEII the highest score, the difference between groups were statistically significant (P < 0.05).The actual mortality in the study was 26.67%, and the estimated mortality rate was about 30.15%, with no significant difference (P > 0.05).No actual mortality in group MODS was 12.12%, lower than the expected mortality rate of 18.67%, the actual mortality of patients in the MODS group was 75.36%, significantly higher than the expected mortality rate of 46.17%, the difference between the two groups were statistically significant (P < 0.05).Conclusion: APACHEII can predict mortality and risk of disease, but the prediction results for patients with MODS are not very satisfactory.The MODS score is more inclined to the evaluation of organ function.The APACHEII scoring system introduced MODS scoring system, can improve the integrity and accuracy of prediction, which has a good effect for the treatment and monitoring of emergency internal medicine in critically ill patients, can control the disease effectively, reduce disease mortality.