摘要
目的:分析比较在心脏瓣膜置换术后应用急性生理学和慢性健康状况评分Ⅲ(APACHEⅢ)、MODS和SOFA 评分系统对患者预后评估的临床意义。方法:对2004年7~12月在我院行心脏瓣膜置换手术的86例患者,在心脏外科重症监护室(CSICU)期间每日应用APACHEⅢ、MODS和SOFA评分评估其预后,并做统计学分析。结果:三种评分在术后3 d内各自无统计学差异,术后3 d APACHEⅢ评分与MODS评分始终保持正相关关系,但其相关性呈下降趋势(r=0.532,r=0.557,r=0.321;P=0.000,P=0.020,P=0.034);术后3 d APACHEⅢ评分与SOFA 评分相关性显著(r分别为0.420,0.523,0.461;P分别为=0.000,=0.026,=0.018);ICU停留时间与术后3 d 三种评分呈相关性(r分别为0.484.0.510,0.440;P均=0.000);术后医院停留时间与A1、A2、A3有相关性 (r分别为0.431,0.874.0.314;P=0.000,=0.000,=0.005)。结论:对心脏瓣膜置换术后患者,三种评分对患者ICU停留时间均有很好的提示作用,而APACHEⅢ评分可较准确地预测患者术后医院停留时间。
Objective:To analysis the clinic significance of the prognosis assess with acute disease physiology and chron ic health evaluation Ⅲ (APACHE Ⅲ ), multiple organ dysfunction score (MODS) and sequential organ failure assessment (SOFA) for postoperative patients with heart valve replacement surgery. Methods : The prognosis of 86 patients undertook heart valve replacement operation was assessed with APACHE Ⅲ , MODS and SOFA scoring system. Then calculate and compare the scores of 3 methods everyday while they stayed in cardiac surgery intensive care unit (CSICU). Results :There were no difference in first three days postoperatively in each APACHE Ⅲ ,MODS and SOFA Score ,but there was significant correlation among APACHE Ⅲ and MODS (r= 0. 532,r= 0. 557,r= 0.321;P= 0. 000. P=0.020, P=0.034), SOFA (r=0.420, 0.523, 0.461; P=0.000, =0.026, =0.018); The detention times in CSICU and the score of three methods had significant correlation (r=0. 484, 0. 510, 0. 440; P=0. 000 all); The total times in hospital after operation had significant correlation with A1, A2, A3 (r=0. 431, 0. 874, 0. 314; P=0. 000, =0. 000, = 0. 005 respectively), and no correlation with M1, M2, M3 and S1, S2,S3. Conclusion : For the postoperative patients with heart valve replacement surgery, APACHE Ⅲ , MODS, SOFA can well assess the detention times in CSICU, and APACHE Ⅲ can precisely assess the total times in hospital after operation.
出处
《心血管康复医学杂志》
CAS
2006年第3期236-238,共3页
Chinese Journal of Cardiovascular Rehabilitation Medicine
关键词
急性病生理学和长期健康评价Ⅲ
心脏外科手术
预后
Acute disease physiology and chronic health evaluation Ⅲ
Cardiac surgery
Prognosis