目的探究在对重症冠心病患者护理时开展急性生理学及慢性健康状况评分Ⅱ(acute physiology and chronic health evaluation,APACHElI)的护理联合身心综合护理对患者睡眠质量、生活质量的影响。方法在2022年1月至2023年12月重症冠心病患...目的探究在对重症冠心病患者护理时开展急性生理学及慢性健康状况评分Ⅱ(acute physiology and chronic health evaluation,APACHElI)的护理联合身心综合护理对患者睡眠质量、生活质量的影响。方法在2022年1月至2023年12月重症冠心病患者中选择76例,按照数字表随机排序1-76号,奇数序列开展常规护理(38例,对照组),偶数序列开展APACHEⅡ的护理联合身心综合护理(38例,观察组)。针对两组睡眠质量、生活质量以及并发症进行统计。结果针对患者睡眠质量评估,观察组护理后睡眠质量高于对照组,差异有统计学意义(P<0.05)。对比患者生活质量,观察组高于对照组,差异有统计学意义(P<0.05)。针对患者并发症统计,观察组低于对照组,差异有统计学意义(P<0.05)。结论在对重症冠心病患者护理时开展APACHEⅡ的护理联合身心综合护理,可以提升患者睡眠质量以及生活质量,降低并发症发生率,有助于患者恢复。展开更多
目的探讨血小板压积(plateletcrit,PCT)联合收缩压(systolic blood pressure,SBP)和急性生理与慢性健康评分(Acute Physiology and Chronic Health Evaluation,APACHEⅡ评分)对脓毒性休克的预测价值。方法入选2018年1月~2021年12月山西...目的探讨血小板压积(plateletcrit,PCT)联合收缩压(systolic blood pressure,SBP)和急性生理与慢性健康评分(Acute Physiology and Chronic Health Evaluation,APACHEⅡ评分)对脓毒性休克的预测价值。方法入选2018年1月~2021年12月山西省人民医院收治的131例脓毒症患者作为研究对象,记录患者基线资料和临床数据。根据是否发生脓毒性休克,将131例患者分为脓毒症组(n=68)和脓毒性休克组(n=63)。比较两组临床资料,采用二元Logistic回归模型分析发生脓毒性休克的独立危险因素。采用受试者工作特征(receiver operating characteristic,ROC)曲线评价PCT、SBP和APACHEⅡ评分及三者联合对脓毒性休克的预测价值。结果两组患者年龄、性别、C反应蛋白、血小板分布宽度和白细胞计数等比较,差异无统计学意义(P>0.05)。与脓毒症组比较,脓毒性休克组收缩压、舒张压、血小板计数、血小板压积和嗜酸性粒细胞计数显著降低;心率、D二聚体、降钙素原、序贯器官衰竭评估(sequential organ failure assessment,SOFA)评分和APACHEⅡ评分升高,差异有统计学意义(P<0.05)。Logistic回归分析显示,低PCT、低SBP和APACHEⅡ评分是脓毒症休克的独立危险因素。ROC曲线分析显示,PCT、SBP和APACHEⅡ预测脓毒症发生的曲线下面积(area under the curve,AUC)分别为0.653、0.665和0.692,而三者联合后,曲线下面积为0.794。结论血小板压积可作为预测脓毒性休克的指标,与收缩压及APACHEⅡ评分联合能够提高预测脓毒性休克的准确性。展开更多
AIM： Acute pancreatitis （AP） is a process with variable involvement of regional tissues or organ systems. Multifactorial scales included the Ranson, Acute Physiology and Chronic Health Evaluation （APACHE Ⅱ） syst...AIM： Acute pancreatitis （AP） is a process with variable involvement of regional tissues or organ systems. Multifactorial scales included the Ranson, Acute Physiology and Chronic Health Evaluation （APACHE Ⅱ） systems and Balthazar computed tomography severity index （CTSI）. The purpose of this review study was to assess the accuracy of CTSI, Ranson score, and APACHE II score in course and outcome prediction of AP. METHODS： We reviewed 121 patients who underwent helical CT within 48 h after onset of symptoms of a first episode of AP between 1999 and 2003. Fourteen inappropriate subjects were excluded; we reviewed the 107 contrastenhanced CT images to calculate the CTSI. We also reviewed their Ranson and APACHE Ⅱ score. In addition, complications, duration of hospitalization, mortality rate, and other pathology history also were our comparison parameters. RESULTS： We classified 85 patients （79%） as having mild AP （CTSI 〈5） and 22 patients （21%） as having severe AP （CTSI ≥5）. In mild group, the mean APACHE II score and Ranson score was 8.6±1.9 and 2.4±1.2, and those of severe group was 10.2±2.1 and 3.1±0.8, respectively. The most common complication was pseudocyst and abscess and it presented in 21 （20%） patients and their CTSI was 5.9±1.4. A CTSI ≥5 significantly correlated with death, complication present, and prolonged length of stay. Patients with a CTSI ≥5 were 15 times to die than those CTSI 〈5, and the prolonged length of stay and complications present were 17 times and 8 times than that in CTSI 〈5, respectively. CONCLUSION： CTSI is a useful tool in assessing the severity and outcome of AP and the CTSI ≥5 is an index in our study. Although Ranson score and APACHE II score also are choices to be the predictors for complications, mortality and the length of stay of AP, the sensitivity of them are lower than CTSI.展开更多
Objective:To explore the easily applicable indicators of practical value to evaluate the prognosis of acute respiratory distress syndrome（ARDS）.Methods:Blood and biochemical tests and bloodgas analyses were performe...Objective:To explore the easily applicable indicators of practical value to evaluate the prognosis of acute respiratory distress syndrome（ARDS）.Methods:Blood and biochemical tests and bloodgas analyses were performed upon entry into the ICUs,12 h,24 h,48 h and 72 h after that in 72 ARDS patients（who were admitted to the ICUs of our hospital from January 2000 to December 2009）.Then APACHEⅡscores were achieved by combining relevant physiological parameters and laboratory results.Results:There was a statistical difference between the death group and survival group at different time points upon entering the ICUs in terms of APACHEⅡscore, alveolar-arterial oxygen difference and arterial blood lactate clearance rate.PaO<sub>2</sub>/FiO<sub>2</sub> values were recorded to be statistically different between the death group and survival group 24 h,48 h and 72 h,respectively after entry into the ICUs.In addition,registered linear regression existed between APACHEⅡscore,alveolar-arterial oxygen difference or PaO<sub>2</sub>/FiO<sub>2</sub> value and time. APACHEⅡscore 24 h and 72 h after entering ICUs predicted mortality with an area under the ROC curve（AUC） standing respectively at 0.919 and 0.9SS.Arterial blood lactate clearance rate 12 h, 24 h,48 h and 72 h after entering ICUs predicted mortality with an area under the ROC curve （AUC） at 0.918,0.918,0.909 and 0.991,respectively.Conclusions:APACHEⅡscore applied in combination with arterial blood lactate clearance rate is of clinical significance in assessing the prognosis of ARDS patients.展开更多
目的:探讨优化个体护理用于重症监护室(ICU)重症肺炎患者对其急性生理与慢性健康评分(AcutePhysiology and Chronic Health Evaluation,APACHE Ⅱ)的影响。方法:随机选取本院收治的106例重症肺炎患者,抽样时间为2020年1月至2021年12月,...目的:探讨优化个体护理用于重症监护室(ICU)重症肺炎患者对其急性生理与慢性健康评分(AcutePhysiology and Chronic Health Evaluation,APACHE Ⅱ)的影响。方法:随机选取本院收治的106例重症肺炎患者,抽样时间为2020年1月至2021年12月,采用随机数表法将其分为观察组和对照组,每组各53例。对照组实施常规护理干预,观察组采用优化个体护理干预。观察两组护理前后的APACHE Ⅱ评分,对比两组患者护理前后血清乳酸水平(LCA)、C反应蛋白(CRP)、D-二聚体(D-D)以及氧合指数(OI)水平,记录两组患者的并发症情况及死亡率。结果:护理第1、3、5、7天,两组患者的APACHE Ⅱ评分均明显降低,观察组的APACHE Ⅱ评分均显著低于对照组,差异有统计学意义(P<0.05)。护理前,两组患者各项生理指标相比,差异无统计学意义(P>0.05);护理后,观察组的LCA、CRP、D-D、OI水平均明显低于对照组,差异有统计学意义(P<0.05)。观察组患者并发症总发生率为1.89%、死亡率为1.89%,明显低于对照组并发症总发生率14.09%、死亡率13.21%,差异有统计学意义(P<0.05)。结论:优化个体护理在ICU重症肺炎患者护理中发挥着积极作用,不仅能改善患者APACHE Ⅱ评分,取得更好的预后效果,更能降低病死率,值得临床推广使用。展开更多
文摘目的探究在对重症冠心病患者护理时开展急性生理学及慢性健康状况评分Ⅱ(acute physiology and chronic health evaluation,APACHElI)的护理联合身心综合护理对患者睡眠质量、生活质量的影响。方法在2022年1月至2023年12月重症冠心病患者中选择76例,按照数字表随机排序1-76号,奇数序列开展常规护理(38例,对照组),偶数序列开展APACHEⅡ的护理联合身心综合护理(38例,观察组)。针对两组睡眠质量、生活质量以及并发症进行统计。结果针对患者睡眠质量评估,观察组护理后睡眠质量高于对照组,差异有统计学意义(P<0.05)。对比患者生活质量,观察组高于对照组,差异有统计学意义(P<0.05)。针对患者并发症统计,观察组低于对照组,差异有统计学意义(P<0.05)。结论在对重症冠心病患者护理时开展APACHEⅡ的护理联合身心综合护理,可以提升患者睡眠质量以及生活质量,降低并发症发生率,有助于患者恢复。
文摘目的探讨血小板压积(plateletcrit,PCT)联合收缩压(systolic blood pressure,SBP)和急性生理与慢性健康评分(Acute Physiology and Chronic Health Evaluation,APACHEⅡ评分)对脓毒性休克的预测价值。方法入选2018年1月~2021年12月山西省人民医院收治的131例脓毒症患者作为研究对象,记录患者基线资料和临床数据。根据是否发生脓毒性休克,将131例患者分为脓毒症组(n=68)和脓毒性休克组(n=63)。比较两组临床资料,采用二元Logistic回归模型分析发生脓毒性休克的独立危险因素。采用受试者工作特征(receiver operating characteristic,ROC)曲线评价PCT、SBP和APACHEⅡ评分及三者联合对脓毒性休克的预测价值。结果两组患者年龄、性别、C反应蛋白、血小板分布宽度和白细胞计数等比较,差异无统计学意义(P>0.05)。与脓毒症组比较,脓毒性休克组收缩压、舒张压、血小板计数、血小板压积和嗜酸性粒细胞计数显著降低;心率、D二聚体、降钙素原、序贯器官衰竭评估(sequential organ failure assessment,SOFA)评分和APACHEⅡ评分升高,差异有统计学意义(P<0.05)。Logistic回归分析显示,低PCT、低SBP和APACHEⅡ评分是脓毒症休克的独立危险因素。ROC曲线分析显示,PCT、SBP和APACHEⅡ预测脓毒症发生的曲线下面积(area under the curve,AUC)分别为0.653、0.665和0.692,而三者联合后,曲线下面积为0.794。结论血小板压积可作为预测脓毒性休克的指标,与收缩压及APACHEⅡ评分联合能够提高预测脓毒性休克的准确性。
文摘AIM： Acute pancreatitis （AP） is a process with variable involvement of regional tissues or organ systems. Multifactorial scales included the Ranson, Acute Physiology and Chronic Health Evaluation （APACHE Ⅱ） systems and Balthazar computed tomography severity index （CTSI）. The purpose of this review study was to assess the accuracy of CTSI, Ranson score, and APACHE II score in course and outcome prediction of AP. METHODS： We reviewed 121 patients who underwent helical CT within 48 h after onset of symptoms of a first episode of AP between 1999 and 2003. Fourteen inappropriate subjects were excluded; we reviewed the 107 contrastenhanced CT images to calculate the CTSI. We also reviewed their Ranson and APACHE Ⅱ score. In addition, complications, duration of hospitalization, mortality rate, and other pathology history also were our comparison parameters. RESULTS： We classified 85 patients （79%） as having mild AP （CTSI 〈5） and 22 patients （21%） as having severe AP （CTSI ≥5）. In mild group, the mean APACHE II score and Ranson score was 8.6±1.9 and 2.4±1.2, and those of severe group was 10.2±2.1 and 3.1±0.8, respectively. The most common complication was pseudocyst and abscess and it presented in 21 （20%） patients and their CTSI was 5.9±1.4. A CTSI ≥5 significantly correlated with death, complication present, and prolonged length of stay. Patients with a CTSI ≥5 were 15 times to die than those CTSI 〈5, and the prolonged length of stay and complications present were 17 times and 8 times than that in CTSI 〈5, respectively. CONCLUSION： CTSI is a useful tool in assessing the severity and outcome of AP and the CTSI ≥5 is an index in our study. Although Ranson score and APACHE II score also are choices to be the predictors for complications, mortality and the length of stay of AP, the sensitivity of them are lower than CTSI.
基金sponsored by Guangdong Science and Technology Project(No:2009B03081118)
文摘Objective:To explore the easily applicable indicators of practical value to evaluate the prognosis of acute respiratory distress syndrome（ARDS）.Methods:Blood and biochemical tests and bloodgas analyses were performed upon entry into the ICUs,12 h,24 h,48 h and 72 h after that in 72 ARDS patients（who were admitted to the ICUs of our hospital from January 2000 to December 2009）.Then APACHEⅡscores were achieved by combining relevant physiological parameters and laboratory results.Results:There was a statistical difference between the death group and survival group at different time points upon entering the ICUs in terms of APACHEⅡscore, alveolar-arterial oxygen difference and arterial blood lactate clearance rate.PaO<sub>2</sub>/FiO<sub>2</sub> values were recorded to be statistically different between the death group and survival group 24 h,48 h and 72 h,respectively after entry into the ICUs.In addition,registered linear regression existed between APACHEⅡscore,alveolar-arterial oxygen difference or PaO<sub>2</sub>/FiO<sub>2</sub> value and time. APACHEⅡscore 24 h and 72 h after entering ICUs predicted mortality with an area under the ROC curve（AUC） standing respectively at 0.919 and 0.9SS.Arterial blood lactate clearance rate 12 h, 24 h,48 h and 72 h after entering ICUs predicted mortality with an area under the ROC curve （AUC） at 0.918,0.918,0.909 and 0.991,respectively.Conclusions:APACHEⅡscore applied in combination with arterial blood lactate clearance rate is of clinical significance in assessing the prognosis of ARDS patients.
文摘目的:探讨优化个体护理用于重症监护室(ICU)重症肺炎患者对其急性生理与慢性健康评分(AcutePhysiology and Chronic Health Evaluation,APACHE Ⅱ)的影响。方法:随机选取本院收治的106例重症肺炎患者,抽样时间为2020年1月至2021年12月,采用随机数表法将其分为观察组和对照组,每组各53例。对照组实施常规护理干预,观察组采用优化个体护理干预。观察两组护理前后的APACHE Ⅱ评分,对比两组患者护理前后血清乳酸水平(LCA)、C反应蛋白(CRP)、D-二聚体(D-D)以及氧合指数(OI)水平,记录两组患者的并发症情况及死亡率。结果:护理第1、3、5、7天,两组患者的APACHE Ⅱ评分均明显降低,观察组的APACHE Ⅱ评分均显著低于对照组,差异有统计学意义(P<0.05)。护理前,两组患者各项生理指标相比,差异无统计学意义(P>0.05);护理后,观察组的LCA、CRP、D-D、OI水平均明显低于对照组,差异有统计学意义(P<0.05)。观察组患者并发症总发生率为1.89%、死亡率为1.89%,明显低于对照组并发症总发生率14.09%、死亡率13.21%,差异有统计学意义(P<0.05)。结论:优化个体护理在ICU重症肺炎患者护理中发挥着积极作用,不仅能改善患者APACHE Ⅱ评分,取得更好的预后效果,更能降低病死率,值得临床推广使用。
