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为分析急性病理生理和慢性健康评分（APACHEⅡ）与外科危重病预告的关系、急性肝功能障碍和衰竭对APACHEⅡ评分及其预后预测意义的影响、探讨肝功不全参数的应用和意义，对1991年5月～1995年9月外科重症监护室（SICU）182例患者，根据转入时状况评分，此后定期再重复评分；用死亡率预测方程（MPM）预测病死率，和实际病死率相对比，并用肝功不全参数作校正。结果：本组平均APACHEⅡ评分18．22分，预测病况率略低于实际病死率。肝功能障碍／衰竭27例，平均APACHEⅡ评分为20．8分，预测病死率为37.5％，实际病死率为70．4％，差异有非常显著性（P＜0．001）。给予肝功不全参数后全组预测病死率为35.3％，肝功能障碍／衰竭组为68.5％，校正后与实际差异无显著性。本文结果提示：APACHEⅡ评分在外科ICU中的应用有预测死亡率的作用。但因肝功能障碍评估不计入评分，使实际病死率高于预测病死率，因此在普外ICU应用时增加一个肝功不全校正参数。以增强其预测预后的意义。
To analyze the relationship between acute pathophysiology and chronic health score (APACHE Ⅱ) and the prognosis of critical care surgery, acute liver dysfunction and failure on the APACHE Ⅱ score and its prognostic significance, to explore the application and significance of hepatic insufficiency parameters, on 1991 From May to September 1995, 182 patients in the SICU were scored on a recurrence-based basis at the time of entry, and were subsequently repeated on a repeat basis. Mortality prediction was used to predict the mortality, as opposed to actual mortality, And liver failure parameters for correction. Results: The average APACHE Ⅱ score 18.22 points in this group, the predicted disease rate slightly lower than the actual mortality. 27 cases of liver dysfunction / failure, the average APACHE Ⅱ score was 20.8 points, the predicted mortality was 37.5%, the actual mortality was 70.4%, the difference was significant (P <0.001). After the parameters of hepatic insufficiency were given, the predicted mortality was 35.3% in the whole group and 68.5% in the liver dysfunction / failure group. There was no significant difference between the corrected and the actual ones. Our results suggest that the use of APACHE II score in surgical ICU has the effect of predicting mortality. However, assessment of liver dysfunction is not included in the score, the actual mortality rate is higher than the predicted mortality, so the application of a universal ICU to add a liver dysfunction correction parameters. To enhance the significance of its prognosis.