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ICU患者APACHEⅡ评分与医院感染发生率及死亡率评价一致性的观察
作者:陈科帆1  李如玉2  熊域皎1  袁术生1 
单位:1. 乐山市人民医院 感染科, 四川 乐山 614000;
2. 乐山市人民医院 重症医学科, 四川 乐山 614000
关键词:医院感染 急性生理学及慢性健康状况评分系统Ⅱ评分 重症监护室 预后 
分类号:R197.323.4
出版年·卷·期(页码):2017·36·第十期(1435-1438)
摘要:

目的:探讨重症监护室(ICU)患者急性生理学及慢性健康状况评分系统Ⅱ(APACHEⅡ)评分与医院感染发生率及预后评价的一致性。方法:纳入我院2015年10月至2016年10月ICU收治的600例患者,根据APACHEⅡ评分的不同分为重症组(评分≤ 15分)、危重症组(评分16~35分)和极危重症组(评分>35分),比较3组患者的医院感染及死亡情况,并对APACHEⅡ评分与医院感染发生率、患者死亡率相关性进行分析。结果:600例患者中共有54例(9.00%)发生医院感染,感染部位以下呼吸道为主(44.44%),其次为泌尿道(22.22%)和胃肠道(16.67%)。极危重症组和危重症组患者的医院感染发生率显著高于重症组,而极危重症组又明显高于危重症组(P<0.05)。APACHEⅡ评分≤ 15分组与>15分组患者的医院感染部位构成比差异无统计学意义(P>0.05)。相关性分析显示,APACHEⅡ评分与患者的医院感染率、死亡率均呈正相关关系(r=0.534、0.338,P<0.05)。结论:APACHEⅡ评分与ICU患者的医院感染率及预后情况密切相关,可为预测患者疾病严重程度、发展趋势和预后提供参考。

Objective: To investigate the consistency of acute physiology and chronic health evaluation scoring system Ⅱ(APACHE Ⅱ) score with nosocomial infection incidence and prognosis evaluation in ICU patients.Methods: Six hundred patients admitted to ICU in our hospital from October 2015 to October 2016 were divided into severe group(<15 points), critical group(16-35 points) and extremely critical group(>35 points) according to the APACHE score, and the correlation between APACHEⅡ score with nosocomial infection incidence and mortality were analyzed. Results: In the 600 patients, nosocomial infection occurred in 50 cases(9.00%), the main site of infection was in the lower respiratory tract(44.44%), followed by urinary tract infection(22.22%) and the gastrointestinal infection(16.67%). The incidence of nosocomial infection in critical group and extremely critical was significantly higher than that in severe group(P<0.05). There was no significant difference in the proportions of nosocomial infection sites between patients with APACHEⅡ score ≤ 15 and those with> 15 groups(P>0.05). The correlation analysis showed that APACHEⅡ score had a positive correlation with nosocomial infection incidence and mortality(P<0.05).Conclusion: APACHEⅡ score is closely related to the hospital infection incidence and prognosis of ICU patients, which provides a reference for the prediction of the disease severity,trends and prognosis.

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