【摘要】 目的评估急性生理学与慢性健康状况评分Ⅱ(APACHEⅡ)在预测综合ICU产科危重患者的病情预后中的应用效果。方法连续观察2000年1月~2004年4月转入GICU资料完整产科危重患者81例,应用APECHEⅡ评分预测死亡风险率,并进行验证。结果81例产科危重患者APACHEⅡ评分范围6~56分,平均为(20.02±9.55)分;64例生存者评分为(18.24±6.95)分;17例死亡者评分为(30.39±10.54)分,两者差异有显著性P<0.001;随着APACHEⅡ评分的增高,预测死亡风险的阳性率逐渐升高;APACHEⅡ评分对以非产科医学指征转入GICU患者的死亡风险预测的阳性率可高达93.03%,而对以产科指征转入者其阳性率仅为30.91%。结论APACHEⅡ评分系统能在一定程度上评价产科危重患者疾病的严重程度和预测预后,尤其对妊娠合并内外科危重疾病患者的预后评估有较好的价值。但产科危重患者是一独特的群体,APACHEⅡ评分系统的应用有一定的局限性,有必要开发一种产科危重患者专用的病情严重程度及预后的评估系统。更多还原

【Abstract】 Objective To determine the predictability of Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ) scoring system for critically ill obstetric patients admitted to general intensive care unit(GICU).Methods Clinic records of consecutive critically ill obstetric patients(n =81) admitted to GICU from Jan 2000 to Apr 2004,were reviewed and evaluated by APACHE Ⅱ.The accuracy of APACHE Ⅱ for obstetric and non-obstetric patients was compared.Results APACHE Ⅱ scores of these critically ill obstetric patients were in the range of 6 to 56,average at(20.02±9.55),with average score of(18.24±6.95) for 64 survivors and(30.39±10.54) for 17 deaths;the difference between two groups was significant(P<0.001).The predicted mortality increased with the increase of APACHE Ⅱ scores.The accuracy of APACHE Ⅱ in predicting mortality of patients admitted to the GICU for non-obstetric indications(93.03%) was much higher than those for obstetric indications(30.91%).Conclusions To some extent,APACHE Ⅱ can be used to predict the prognosis of critically ill obstetric patients admitted to GICU,especially for those admitted to GICU for non-obstetric indications.An optimal evaluating system for those with obstetric indications should be developed.更多还原