两种评分对NICU医院感染风险的临床研究

Clinical research on two scorings on risk for nosocomial infections in neurological intensive care unit

目的探讨格拉斯哥昏迷评分(GCS)与急性生理功能及慢性健康状况评分Ⅱ(APACHEⅡ)用于神经内科重症监护病房(NICU)医院感染风险预警的可行性。方法回顾性的对216例NICU患者进行入院<24hGCS评分和APACHEⅡ评分,依据评分结果将患者分组,研究组间医院感染率、平均住院日及器械使用日的统计差异性。结果按照APACHEⅡ评分分组的高、中及低危组患者的医院感染率分别为28.6%、19.7%、7.5%,差异有统计学意义(P<0.05);各组患者的平均住院日和器械使用日之间比较,差异有统计学意义(P<0.05)。结论GCS与APACHEⅡ评分不仅可用于NICU患者医院感染风险预警,还可用于患者住院日和器械使用日的初步预测。

OBJECTIVE To approach the feasibility and accuracy of using glasgow coma scale（GCS） and acute physiology and chronic health evaluation（APACHEⅡ） for the neurological intensive care unit（NICU） nosocomial infection risk warning.METHODS Two hundreds and sixteen patients in NICU within 24 h of admission were retrospectively evaluated with GCS and APACHEⅡ systems and divided into three groups based on the scores of GCS or APACHEⅡ.The statistic differences of nosocomial infection ratios,the average patient-days and device-days between groups were studied.RESULTS The nosocomial ratios of high-risk,middle-risk and low-risk groups of NICU patients divided with APACHEⅡ scores were 28.6%,19.7% and 7.5%,respectively,with significantly statistical differences（P〈0.05）.The average patient-days and device-days of each group also had significantly statistical differences（P〈0.05）.CONCLUSION GCS and APACHEⅡ systems can be used not only for the risk warning of nosocomial infection of NICU patients,but also for the early prediction of device-days.