APACHE、RANSON评分在重症急性胰腺炎中的应用价值

EVALUATION OF APACHEⅡ AND RANSON SCORING SYSTEM IN SEVERE ACUTE PANCREATITIS.

目的 分析 APACHE 、RANSON评分在预测重症急性胰腺炎 (SAP)病情和预后以及指导治疗中的应用价值。方法 运用 APACHE 、RANSON评分系统对 94例 SAP病人进行回顾性评分。结果 依据 APACHE 系统 ,器官功能障碍组评分明显高于无器官功能障碍组 ,高分组器官功能障碍发生率明显高于低分组 (P<0 .0 5 ) ;死亡组评分明显高于存活组 ,高分组病死率明显高于低分组 (P<0 .0 5 ) ;手术组和非手术组之间评分无显著性差异 ,高分组和低分组之间手术率亦无显著性差异 (P>0 .0 5 )。依据 Ranson系统 ,有无器官功能障碍、存活死亡以及手术非手术组之间评分均无显著性差异 (P>0 .0 5 )。结论 APACHE 评分对于判断 SAP病情及预后有重要参考意义 ,而 Ranson应用价值不稳定 。

Objective To study the value of acute physiology,age and chronic health evaluation Ⅱ(APACHEⅡ)and Ranson scoring on predicting the severity and prognosis and indicating clincal agents of severe acute pancreatitis(SAP).Methods A total of 94 patients with SAP were analyzed with APACHEⅡand Ranson criteria retrospectively.Result According to APACHEⅡ scoring system,the group with organ dysfunction was significantly higher than the group without it(P<0.05).The incidence of organ failure in high score group was more than that in low score group (P<0.05).The APACHEⅡ score in death cases was higher than that in survival cases(P<0.05).Obvious difference of mortality was showed between high score group and the low one(P<0.05).Patients treated with operation and conservatively showed no difference in APACHEⅡ score(P>0.05),and there was no significant difference between these two groups in operation rate(P>0.05),and there was no significant difference bwtween these two groups in operation rate(P>0.05).According to Ranson scoring system,there was no significant difference between organ dysfunction patients and negative one(P>0.05).The Ranson score in survival cases was not different with death cases(P>0.05).Patients treated with operation and conservatively showed no difference in Ranson score(P>0.05).Conclusion The APACHEⅡ scoring system could be used as an important reference in evaluation the severity and prognosis of SAP,but the value of Ranson criteria is not stable.Neither of the two systems can indicate surgical agents independently.