【摘要】 [目的]探讨采用急性生理和慢性健康评价系统Ⅱ(APACHEⅡ)、简化急性生理评分2(SAPS2)、病死概率模型Ⅱ(MPMⅡ)3种常用的疾病严重程度评分系统对重症监护室(ICU)病人进行护理分级的可行性。[方法]选取某三级甲等医院在ICU接受监护的病人300例,应用APACHEⅡ、SAPS2、MPMⅡ3种疾病严重程度评分系统进行横断面调查,以"ICU重症病人ABCD护理分级管理方法"作为校标,应用ROC曲线下面积比较这3种评分系统对ICU病人进行护理分级的效果。[结果]APACHEⅡ、SAPS2、MPMⅡ3种评分系统与ICU重症病人ABCD护理分级均呈正相关(P<0. 01);SAPS2对A级病人的分辨能力(AUC=0. 698)略高于APACHEⅡ(AUC=0. 639)、MPMⅡ(AUC=0. 651);3种评分系统对A级+B级病人的分辨能力高于对A级病人的分辨能力(P<0. 001),而MPMⅡ对A级+B级病人的分辨能力(AUC=0. 735)优于APACHEⅡ(AUC=0. 695)、SAPS2(AUC=0. 695)。[结论]APACHEⅡ、SAPS2、MPMⅡ3种评分系统与ICU重症病人ABCD护理分级均相关,应用SAPS2、MPMⅡ区分ICU病人护理分级效果较好。更多还原

【Abstract】 Objective:To explore the feasibility of using APACHE Ⅱ,SAPS2,MPM Ⅱ three commonly used disease severity scoring systems to classify the nursing grading of ICU patients.Methods:A cross-sectional study was conducted on 300 ICU patients in a tertiary hospital.APACHE Ⅱ,SAPS2 and MPM Ⅱ disease severity scoring systems were used to assess the severity of ICU patients.The "ABCD nursing classification management method for ICU patients" was used as the criterion to correlate the validity and the ROC curve was used to compare the effect of nursing grade of three scoring systems in ICU patients.Results:APACHE Ⅱ,SAPS2 and MPM Ⅱ were positively correlated with the ABCD nursing classsification of ICU patients(P<0.01).The ability of SAPS2 to distinguish patients of grade A(AUC=0.698) was slightly higher than that of APACHE Ⅱ(AUC=0.639) and MPM Ⅱ(AUC=0.651).The distinction ability of three scoring systems for A+B patients were higher than that of A patients(P<0.001),while the distinction ability of MPM Ⅱ for A+B patients(AUC=0.735) was better than those of APACHE Ⅱ(AUC=0.695) and SAPS2(AUC=0.695).Conclusion:The three scoring systems,APACHEE Ⅱ,SAPS2 and MPM Ⅱ were all correlated with the ABCD nursing classification of ICU patients.Among them,SAPS2 and MPM Ⅱ had good effect in classifying the nursing grading of ICU patients.更多还原