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目的应用动态急性生理学及慢性健康状况评估Ⅲ(APACHEⅢ)评估重症监护病房(ICU)患者的病情及预后;同时对比动态APACHEⅢ评分,多器官功能障碍综合征(MODS)评分预测患者预后与实际预后的关系。方法收集整理286例危重症患者资料,分为存活组252例,死亡组34例,比较两组第1、3、5、7天应用APACHEⅢ系统评分,同时进行MODS评分及预后预测。结果第1、3、5、7天APACHEⅢ分值和预测病死率死亡组均高于存活组(P<0.05或P<0.01),动态评分更有助预后判断;APACHEⅢ评分与MODS评分高低有一致性;MODS评分与死亡率有关。结论动态APACHEⅢ评分系统联合MODS评分系统可用于ICU病房患者病情及预后评估,是医疗质量及合理利用ICU资源的依据。
Objective To evaluate the prognosis and prognosis of patients with intensive care unit (ICU) by using dynamic acute physiology and chronic health assessment Ⅲ (APACHE Ⅲ), and to evaluate the prognosis and prognosis of patients with ICU by dynamic APACHE Ⅲ score and multiple organ dysfunction syndrome (MODS) relationship. Methods A total of 286 critically ill patients were collected and divided into 252 survivors and 34 deaths. The APACHE Ⅲ system scores were compared on the 1st, 3rd, 5th and 7th days in the two groups. MODS score and prognosis were also compared. Results APACHE Ⅲ scores and predicted mortality rates on the 1st, 3rd, 5th and 7th days were significantly higher than those in the survivors (P <0.05 or P <0.01). The dynamic score was more helpful for predicting the prognosis. The APACHE Ⅲ score was consistent with the MODS score Sex; MODS score and mortality. Conclusions The dynamic APACHE III scoring system combined with MODS scoring system can be used to evaluate the condition and prognosis of patients in ICU ward. It is the basis of medical quality and rational utilization of ICU resources.