APACHEⅢ评分及氧合指数与老年重症肺炎治疗效果及预后的关系研究

APACHE Ⅲ score and oxygenation index in elderly patients with severe pneumonia curative effect and prognosis

目的:探讨APACHEⅢ评分与氧合指数在判断老年重症肺炎治疗效果及预后中的价值。方法:将2009年1月～2011年12月我科收治的87例老年重症肺炎患者根据治疗结局分为存活组和死亡组,根据动脉血气、氧合指数及APACHEⅢ评分结果,分析APACHEⅢ评分与氧合指数对预后的影响。结果:本组87例患者37例存活,50例死亡,总死亡率为57.47%。存活组入院时和治疗后第3、5、7天APACHEⅢ评分、氧合指数与死亡组比较均有显著差异(P<0.05)。死亡组患者APACHEⅢ评分随住院天数延长而显著增高,而氧合指数则随着住院天数延长而逐渐降低,存活组与之相反。氧合指数与APACHEⅢ评分呈负相关(r=-0.7387,P<0.01)。结论:APACHEⅢ评分及氧合指数可以作为临床判断老年重症肺炎患者的病情危重程度、治疗效果及预后的重要指标。

Objective To explore the value of APACHE III score and the oxygenation index （PaOJFiO~） on the prognosis of the severe pneumonia of the elderly patients. Methods 56 cases of patients admitted in the Department of Respiratory medicine of the Huai＇an Hospital ＆ffiliated to Xuzhou Medical College were collected and analyzed. According to the clinical prognosis,the patients were divided into death and survival group in which the impact of APACHE Ⅲ score and the oxygenation index on the clinical prognosis were compared. Results There were significant differences （P〈0.05） between the death group and survival group in APACHE Ⅲ score and the oxygenation index. APACHE Ⅲ score in the death group increased together with the duration of hospitalization and on the contrary, the oxygenation index scores decreased. In contrast to APACHEⅢ score in the survival group decreased together with the duration of hospitalization,while the oxygenation index scores increased. The oxygenation index scores negatively correlated with APACHE III （r=-0.7542, P〈0.01）. Conclusion APACHE IH score and the oxygenation index can be used for evaluation of severity of the severe pneumonia of the elderly patients. Dynamic observation of APACHE Ⅲ score and the oxygenation index will help to direct the treatment and predict the clinical prognosis.