门急诊患者危重症的筛查及处理

Emergency department screening and treatment of critically ill patients

目的通过探索制定的潜在危重症患者的筛查程序,减少临床上的误诊误治,提高危重症的救治成功率。方法选取2010年1月至2012年1月急诊治疗的危重症患者292例,采用APACHEII评分系统评分并计算预计死亡危险度,比较其与患者实际病情转归的差异。结果①存活患者的A-PACHEII评分与预计死亡危险度均明显低于死亡患者(t=7.94,t=9.40;P<0.05;)②有患者的A-PACHEII评分下的预计死亡危险度为13.81%,实际病死率为9.9%,经校准度衡量,无明显差异(P>0.05),提示APACHEII评分对于预后的分析较为准确。结论潜在危重症患者的筛查程序,能快速筛选出需要紧急抢救的危重患者,提高抢救效益及质量。

Objective To explore the development of potential by critically ill patients screening program,reduce clinical misdiagnosis and mistreatment,improve the success rate of treatment of critically ill patients.Methods From 2010January-2012January of emergency treatment of292 critically ill patients,using APACHE II scoring system and the calculation of the expected score of risk of death of patients,compared with the actual prognosis difference.Results The survival in patients with APACHE II score and predict risk of death were significantly lower than those of dead patients（t= 7.94,t=9.40;P〈 0.05;APACHE） the patients with II score of expected death risk was 13.81%,the mortality rate was 9.9%,the calibration measurement,no difference（P〉 0.05）,APACHE II prompts for prognostic analysis more accurate score.Conclusion The potential of critically ill patients with the screening procedures,can quickly screen out need for emergency rescue of critically ill patients,improving the rescue efficiency and quality.