APACHEⅡ评分系统与慢性阻塞性肺疾病呼吸衰竭患者机械通气的相关性研究

The study on the correlation between acute physiology and chronic health evaluation Ⅱ and mechanical ventilation of COPD patients with respiratory failure

目的研究慢性阻塞肺疾病(COPD)呼吸衰竭患者的主要临床参数与实施机械通气指征的关系。方法对我院急诊科及ICU收治的62例COPD呼吸衰竭患者入院24h内的临床资料进行回顾性分析,在不同分组下进行比较。结果不同分值段之间APACHEⅡ分值,预计死亡危险度,有机械通气率差异有显著意义(P<0.05);有机械通气指征组APACHEⅡ分值、预计死亡危险度高于无机械通气指征组,差异有意义(P<0.05);逐步Logistic回归分析显示APACHEⅡ分值,预计死亡危险度与机械通气指征正相关(P<0.05)。结论APACHEⅡ评分系统对COPD呼吸衰竭患者的机械通气有预测价值,适合引入为通气指征。

Objective To evaluate the correlation between acute physiology and chronic health evaluation Ⅱ （APACHE Ⅱ ） score in COPD patients with respiratory failure treated with mechanical ventilations. Methods The clinical data of 62 COPD patients with respiratory failure have been reviewed in last three years in the emergency department and ICU, and were compared among different groups. Results The APACHE Ⅱ score, their predicted hospital mortality and the radio of mechanical ventilation scores were different in different scopes of APACHE Ⅱ scores （P 〈0.05）. The APACHE Ⅱ score and their predicted hospital mortality in group with mechanical ventilation standard were much higher than in the group without mechanical ventilation standard （ P 〈 0. 05 ）. The logistic regression analysis showed that mechanical ventilation of COPD patients with respiratory failure was positively correlated with the APACHE Ⅱ score and their predicted hospital mortality （P 〈 0. 05）. Conclusion APACHE Ⅱ is applicable to COPD patients with respiratory failure, which may become a standard of mechanical ventilation.