CAJ | 학술논문

目的通过分析我院体外膜肺氧合(ECMO)患者入院时的APACHEⅡ评分,评估其在ECMO治疗中的临床应用价值.方法选取2008年4月至2011年8月在我院行ECMO治疗的患者共25例,按照患者接受ECMO治疗的预后分为存活组及死亡组,取患者各项监测及化验检查的最差值进行APACHEⅡ评分,比较两组的分值.结果存活组共10例,入院时APACHEⅡ评分为(33.0±2.9)分；死亡组共15例,入院时APACHEⅡ评分为(47.3±4.5)分,组间比较差异有统计学意义(t=8.896,P＜0.05).按照APACHEⅡ的急性生理学评分标准,对存活组及死亡组患者进行相关临床指标评分,其中存活组体温评分为(1.4±0.8)分、平均动脉压为(2.4±0.5)分、心率为(2.2±0.4)分、呼吸为(1.6±1.0)分、氧分压为(2.3±0.5)分、肺泡气-动脉氧分压差为(2.1±0.6)分、pH值为(1.1±0.7)分、血钾为(1.8±0.8)分、血钠为(2.1±0.9)分、红细胞比容为(1.4±1.1)分,格拉斯哥昏迷评分为(7.2±1.0)分；死亡组分别为(2.5±0.8)、(3.0±0.7)、(2.7±0.6)、(2.5±1.0)、(2.8±0.9)、(3.1±0.5)、(3.1±0.6)、(2.7±0.6)、(2.9±0.6)、(2.5±1.1)、(9.1±1.8)分,两组比较差异均有统计学意义(P均＜0.05),其中存活组的上述急性生理学评分更低.结论 APACHEⅡ评分能够客观评估ECMO治疗的成功率,同时为实施ECMO抢救的时机及纳入标准提供量化指标.
목적 통과분석아원체외막폐양합(ECMO)환자입원시적APACHEⅡ평분,평고기재ECMO치료중적림상응용개치.방법 선취2008년4월지2011년8월재아원행ECMO치료적환자공25례,안조환자접수ECMO치료적예후분위존활조급사망조,취환자각항감측급화험검사적최차치진행APACHEⅡ평분,비교량조적분치.결과 존활조공10례,입원시APACHEⅡ평분위(33.0±2.9)분；사망조공15례,입원시APACHEⅡ평분위(47.3±4.5)분,조간비교차이유통계학의의(t=8.896,P＜0.05).안조APACHEⅡ적급성생이학평분표준,대존활조급사망조환자진행상관림상지표평분,기중존활조체온평분위(1.4±0.8)분、평균동맥압위(2.4±0.5)분、심솔위(2.2±0.4)분、호흡위(1.6±1.0)분、양분압위(2.3±0.5)분、폐포기-동맥양분압차위(2.1±0.6)분、pH치위(1.1±0.7)분、혈갑위(1.8±0.8)분、혈납위(2.1±0.9)분、홍세포비용위(1.4±1.1)분,격랍사가혼미평분위(7.2±1.0)분；사망조분별위(2.5±0.8)、(3.0±0.7)、(2.7±0.6)、(2.5±1.0)、(2.8±0.9)、(3.1±0.5)、(3.1±0.6)、(2.7±0.6)、(2.9±0.6)、(2.5±1.1)、(9.1±1.8)분,량조비교차이균유통계학의의(P균＜0.05),기중존활조적상술급성생이학평분경저.결론 APACHEⅡ평분능구객관평고ECMO치료적성공솔,동시위실시ECMO창구적시궤급납입표준제공양화지표.
Objective To assess the clinical value of extracorporeal membrane oxygenation(ECMO)treatment,we analyzed our hospital ECMO patients on admission APACHE Ⅱ score.Methods Twenty-five ECMO patients in our hospital from April 2008 to August 2011 were included and divided into survival group and death group according to the treatment prognosis.The lowest scores of APACHE Ⅱ of both groups were counted respectively,the various monitoring and laboratory tests taken as APACHE Ⅱ scores and compared between the two groups.Results The score of APACHE Ⅱ in 10 patients of survival group was (33.0 ± 2.9)points;Fifteen patients of the death group was (47.3 ± 4.5) points.There were significantly differences in two groups (t =8.896,P ＜ 0.05).According by the Acute Physiology Score of APACHE Ⅱ standard,assessed the relevant clinical indicators rated of the two groups,and results shown that the body temperature ratings for the survival group (1.4 ± 0.8) points,mean arterial pressure (2.4 ± 0.5) points,heart rate (2.2 ± 0.4) points,breathing (1.6 ± 1.0),oxygen partial pressure (2.3 ± 0.5) points,alveolar-arterial oxygen difference (2.1 ± 0.6) points,pH value (1.1 ± 0.7) points,pointspotassium levels (1.8 ± 0.8) points,hyponatremia (2.1 ± 0.9) points,hematocrit was (1.4 ± 1.1) points,Glasgow coma score (7.2 ± 1.0) points; Death group (2.5 ± 0.8),(3.0 ± 0.7),(2.7±0.6),(2.5 ±1.0),(2.8 ±0.9),(3.1 ±0.5),(3.1 ±0.6),(2.7 ±0.6),(2.9 ±0.6),(2.5 ± 1.1),(9.1 ± 1.8) points,the differences between the two groups were statistically significant (P ＜0.05),the acute physiology score is lower in survival group.Conclusion APACHE Ⅱ score can objectively evaluate the the ECMO treatment success rate,as well as the timing of implementation of ECMO rescue and inclusion criteria quantitative indicators.