【摘要】 目的探讨呼吸机相关性肺炎(VAP)的预后与简化临床肺部感染评分(sCPIS)分值及动态变化的相关性及临床意义。方法应用sCPIS对2011年1月至2012年12月广州市红十字会医院重症监护室收治的52例VAP患者进行回顾性评价。对VAP诊断时及诊断后第3、5和7 d的sCPIS分值进行分析。结果住院28 d内死亡28例(53.8%),存活24例(46.2%)。存活组患病后第3、5和7 d的评分较患病时明显下降(4.8±1.2、4.0±1.1、3.3±1.6比5.5±1.4,P<0.05)。死亡组患病后第3、5和7 d的评分较患病时逐渐升高(6.8±1.3、7.5±1.4、7.8±1.2比5.8±1.5,P<0.05)。死亡组患病后第3、5和7 d的评分显著高于相应存活组(P<0.05)。死亡组机械通气时间[(18.4±5.2)d比(12.0±4.1)d]和住ICU时间[(22.5±8.5)d比(16±6.3)d]均显著长于存活组(P<0.05)。结论动态监测sCPIS变化有助于评估VAP患者的病情严重程度,预测患者的预后。更多还原

【Abstract】 Objevtive To assess the value of simplified clinical pulmonary infection score(sCPIS)in predicting prognosis of patients with ventilator-associated pneumonia(VAP). Methods The clinical data of 52 patients with VAP,admitted in ICU between January 2011 and December 2012,were retrospectively analyzed. The sCPIS was calculated at the onset,and on 3rd,5thand 7thday after onset of VAP. Results 24 cases survived and 28 cases died in 28-day’ s hospitalization. 28-day mortality was53. 8%. A significant decrease in sCPIS scores was found on 3rd,5thand 7thday after onset compared with at the onset of VAP in the survivors(4. 8 ± 1. 2,4. 0 ± 1. 1,3. 3 ± 1. 6 vs. 5. 5 ± 1. 4,P < 0. 05). An increase in sCPIS scores was found on 3rd,5thand 7thdays after onset compared with at the onset of VAP in the nonsurvivors(6. 8 ± 1. 3,7. 5 ± 1. 4,7. 8 ± 1. 2 vs. 5. 8 ± 1. 5,P < 0. 05). The sCPIS determined at the time of VAP diagnosis and on 3rd,5thand 7thday after onset was significantly higher in the non-survivors than that in the survivors respectively(P < 0. 05). The duration of mechanical ventilation and the length of ICU stay were longer in the non-survivors than those in the survivors [(18. 4 ± 5. 2) d vs.(12. 0 ± 4. 1) d,(22. 5 ±8. 5) d vs.(16 ± 6. 3) d,P < 0. 05]. Conclusion Serial measurement of sCPIS is valuable in evaluating the severity of illness and predicting the prognosis.更多还原