动态APACHEⅢ联合MODS评分在ICU临床研究中的应用

Application of Dynamic APACHEⅢ and MODS Scoring in ICU Clinical Studies

目的应用动态急性生理学及慢性健康状况评估Ⅲ(APACHEⅢ)评估重症监护病房(ICU)患者的病情及预后;同时对比动态APACHEⅢ评分,多器官功能障碍综合征(MODS)评分预测患者预后与实际预后的关系。方法收集整理286例危重症患者资料,分为存活组252例,死亡组34例,比较两组第1、3、5、7天应用APACHEⅢ系统评分,同时进行MODS评分及预后预测。结果第1、3、5、7天APACHEⅢ分值和预测病死率死亡组均高于存活组(P<0.05或P<0.01),动态评分更有助预后判断;APACHEⅢ评分与MODS评分高低有一致性;MODS评分与死亡率有关。结论动态APACHEⅢ评分系统联合MODS评分系统可用于ICU病房患者病情及预后评估,是医疗质量及合理利用ICU资源的依据。

[Objective] To apply Acute Physiology Chronic Health Evaluation Ⅲ（APACHEⅢ）in evaluation of the ICU patient＇s condition and prognosis,and simultaneously compare the prognosis predicted by dynamic APACHEⅢ scoring and MODS scoring with the actual prognosis.[Methods]The clinical data of 286 critically ill patients were collected and divided into survival group （252 cases） and death group （34 cases）.APACHEⅢ was adopted to evaluate patients of the 2 groups for the 1st,3rd,5th,7th day,the results were compared.MODS scoring and prognosis prediction were simultaneously carried out.[Results]The APACHEⅢ scores of the 1st,3rd,5th,7th day and fatality rate of death group were all higher than those of the survival group（P0.05 or P0.01）.Dynamic scoring could help to determine prognosis.There was consistency between APACHE Ⅲ scoring and MODS scoring.MODS scoring was correlated with mortality.[Conclusion]Dynamic APACHEⅢ and MODS scoring systems can be used for evaluation of the ICU patient＇s condition and prognosis,and it is the evidence of medical quality and rational use of ICU resource.