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目的:探讨急性生理学、慢性健康状况评分(APACHEⅡ评分)及降钙素原(PCT)动态监测严重多发伤患者的价值。方法:35例ISS评分>16分的严重多发伤患者入住重症加强护理病房(ICU),进行APACHEⅡ评分及PCT的动态监测,根据1周后患者预后将35例患者分为存活组(25例)和死亡组(10例),比较两组患者血PCT浓度、APACHEⅡ评分之间的差异,计算APACHEⅡ评分与PCT数值的相关性。结果:患者进入ICU第1天PCT检测结果及APACHEⅡ评分差异无统计学意义。死亡组患者的APACHEⅡ评分呈现逐渐上升的趋势,并于第4天显著高于存活组(P﹤0.05);死亡组患者的PCT水平也呈现逐渐上升的趋势,并于第3天显著高于存活组(P﹤0.05);存活组患者的APACHEⅡ评分和PCT水平在第2天达到峰值后开始逐渐下降,直到治疗结束前都呈下降趋势。动态监测APACHEⅡ评分与PCT检测结果成正相关(P﹤0.05)。结论:严重多发伤患者的动态监测APACHⅡ评分与PCT水平成正相关,对两者进行综合分析可提高对严重多发伤患者预后评估的准确度。
Objective: To investigate the value of acute physiology, chronic health status score (APACHEⅡscore) and procalcitonin (PCT) in the dynamic monitoring of patients with severe multiple trauma. Methods: Thirty-five patients with severe traumatic injury were enrolled in intensive intensive care unit (ICU). APACHEⅡscore and PCT were monitored in 35 patients with ISS score> 16. According to their prognosis, 35 patients were divided into survival group (n = 25) And death group (10 cases). The differences of PCT concentration and APACHEⅡscore between two groups were compared, and the correlation between APACHEⅡscore and PCT value was calculated. Results: There was no significant difference in PCT test results and APACHE Ⅱ score between the first day and the first day of ICU admission. APACHEⅡscore in the death group showed a gradual upward trend, which was significantly higher than that in the surviving group on the fourth day (P <0.05). The PCT level in the death group also showed a gradual upward trend and was significantly higher than the survival on the third day (P <0.05). The APACHEⅡscore and PCT level in survivors decreased gradually after reaching the peak on the second day and decreased until the end of treatment. There was a positive correlation between dynamic monitoring of APACHE Ⅱ score and PCT test (P <0.05). Conclusion: The dynamic monitoring of APACH Ⅱ score in patients with severe multiple traumas has a positive correlation with the level of PCT. The comprehensive analysis of both can improve the accuracy of prognosis evaluation in patients with severe multiple trauma.