CAJ | 학술논문

目的：探讨急诊重症监护病房（EICU)心肺复苏（cardiopulmonary resuscitation, CPR)术后患者急性生理学与慢性健康状况评价系统Ⅱ（acute physiology and chronichealth evaluation, APACHE Ⅱ)评分变化与预后的相关性。方法选择2010年1月—2012年12月我院 EICU 实施 CPR 术后自主循环恢复（ROSC)患者58例,按存活时间分为存活≤24 h 组（31例)和存活>24 h 组（27例),再根据患者最终存活情况,将存活>24 h 组又分为成活出院组（13例)和死亡组（14例),比较各组 ROSC 后1、6 h APACHE Ⅱ评分,两次 APACHE Ⅱ评分差值及评分变化率。结果存活≤24 h 组和存活>24 h 组 ROSC 后1、6 h APACHE Ⅱ评分比较差异无统计学意义（t =0．711,P =0．480；t =1．124, P =0．266),但两组 APACHE Ⅱ评分差值和评分变化率比较差异均有统计学意义（t =2．991,P =0．004；t =3．938,P =0．000)；两组 ROSC 后1、6 h 评分变化率与1 h 评分值无明显相关性（r =0．015,P =0．913)。成活出院组和死亡组ROSC 后1 h APACHE Ⅱ评分比较差异无统计学意义（t =1．867,P >0．05),但6 h 评分比较差异有统计学意义（t =7．024,P <0．01)；两次 APACHE Ⅱ评分差值及评分变化率比较差异均有统计学意义（t =4．151,P <0．01；t =7．334,&nbsp；P <0．01)。结论对于 EICU 实施 CPR 术后患者,APACHE Ⅱ评分变化率能更早期、更准确地预测患者预后。
목적：탐토급진중증감호병방（EICU)심폐복소（cardiopulmonary resuscitation, CPR)술후환자급성생이학여만성건강상황평개계통Ⅱ（acute physiology and chronichealth evaluation, APACHE Ⅱ)평분변화여예후적상관성。방법선택2010년1월—2012년12월아원 EICU 실시 CPR 술후자주순배회복（ROSC)환자58례,안존활시간분위존활≤24 h 조（31례)화존활>24 h 조（27례),재근거환자최종존활정황,장존활>24 h 조우분위성활출원조（13례)화사망조（14례),비교각조 ROSC 후1、6 h APACHE Ⅱ평분,량차 APACHE Ⅱ평분차치급평분변화솔。결과존활≤24 h 조화존활>24 h 조 ROSC 후1、6 h APACHE Ⅱ평분비교차이무통계학의의（t =0．711,P =0．480；t =1．124, P =0．266),단량조 APACHE Ⅱ평분차치화평분변화솔비교차이균유통계학의의（t =2．991,P =0．004；t =3．938,P =0．000)；량조 ROSC 후1、6 h 평분변화솔여1 h 평분치무명현상관성（r =0．015,P =0．913)。성활출원조화사망조ROSC 후1 h APACHE Ⅱ평분비교차이무통계학의의（t =1．867,P >0．05),단6 h 평분비교차이유통계학의의（t =7．024,P <0．01)；량차 APACHE Ⅱ평분차치급평분변화솔비교차이균유통계학의의（t =4．151,P <0．01；t =7．334,&nbsp；P <0．01)。결론대우 EICU 실시 CPR 술후환자,APACHE Ⅱ평분변화솔능경조기、경준학지예측환자예후。
Objective To explore the correlation between the changes of acute physiology and chronic health evalua-tion II (APACHE II) score and the prognoses of post-cardiopulmonary resuscitation (CPR) patients in emergency intensive care unit (EICU). Methods A total of 58 post-CPR patients with restoration of spontaneous circulation ( ROSC) in the EICU between January 2010 and December 2012 were divided into not longer than 24 h group (group A, n = 31) and longer than 24 h (group B, n = 27) according to survival time, and the group B was further divided into the discharged subgroup (n = 13) and the death subgroup (n = 14). The APACHEII scores 1 h and 6 h after ROSC in all groups, different values and change rates of APACHE Ⅱ scores were compared. Results The differences of APACHE II scores 1 h and 6 h after ROSC in group A and B were not statistically significant (t = 0. 711, P = 0. 480; t = 1. 124, P = 0. 266), but the differences of differ-ent values and change rates of APACHE Ⅱ scores in the two groups were statistically significant (t = 2. 991, P = 0. 004; t =3. 938, P = 0. 000); there was no correlation between the change rate of 1 h and 6 h after ROSC with 1 h after ROSC score (r = 0. 015, P = 0. 913). The difference of APACHE II scores 1 h after ROSC in the two subgroups was not statistically signif-icant (t = 1. 867, P > 0. 05), however the difference of APACHE II scores 6 h after ROSC in the two subgroups was signifi-cant (t = 7. 024, P < 0. 01); the differences in different values and change rates of APACHE Ⅱ scores in the two subgroups were also statistically significant ( t = 4. 151, P < 0. 01; t = 7. 334, P < 0. 01). Conclusion The change rate of the APACHE Ⅱ score is an earlier and better prognosis prediction index for the post-CPR patients in EICU.