APACHEⅡ评分对指导CBP治疗重症急性胰腺炎时机选择的研究(1)
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【摘要】目的:探讨APACHEⅡ评分对选择连续性血液净化治疗重症急性胰腺炎最佳时机选择的指导意义。方法:将111例重症急性胰腺炎患者分别按APACHEⅡ评分<15分; 15～25分;>25分分类，每个类别内再分CBP治疗组和非CBP治疗组。在不同APACHEⅡ评分分数段内分别比较行CBP治疗对两组患者的病死率、总住院时间、总医疗费用、ICU住院时间、ICU治疗费用以及使用呼吸机时间的长短等的差异。结果:所有组别内，使用CBP治疗均可以缩短呼吸机使用的时间(P<0.05)。当APACHEⅡ评分<15分时,2组均无患者死亡，但CBP治疗组以增加总治疗费用和ICU治疗费用为代价，缩短了ICU及总的入院时间(P<0.05)。APACHEⅡ评分15～25分时,CBP治疗组患者总住院时间、ICU住院时间以及总的治疗费用和ICU内的治疗费用均明显低于非CBP治疗组(P<0.05)。APACHEⅡ评分>25分时,2组患者病死率无显著差异,但CBP治疗组总住院时间、总医疗费用、ICU内治疗费用明显高于非CBP治疗组(P<0.05)。 结论:当APACHEⅡ评分为15-25分时使用CBP治疗重症胰腺炎可以产生较好的效价比。对于经济环境优渥的患者，15分以下也可以尝试使用以缩短入住ICU的时间，早日达到内环境的稳态。APACHEⅡ评分对临床工作者在SAP的患者进行CBP的时机选择上有一定的指导意义。
【关键词】APACHEⅡ评分；连续性血液净化；重症急性胰腺炎
【中图分类号】R459【文献标识码】A【文章编号】1008-6455(2011)04-0093-02
Study ofAPACHE Ⅱ In SAP Patients TreatedWithCBP
Yan Li1 Huang Yi2 Li ShuSheng1
【Abstract】Objective:To explore the value of acute physiology and chronic health evaluation score (APACHE) Ⅱ in definition optimal opportunity of severe acute pancreatitis(SAP)treated with continue blood purification (CBP). Methods:111 SAP patients were divided into three groups (APACHE Ⅱ <15; APACHE Ⅱ15 to 25; APACHE Ⅱ>25) .In each of APACHE Ⅱ group, patients were divided into CBP and non-CBP group further. Mobility, in-hospital times, in-ICU times, in-ICU costs, in-hospital costs, the duration of mechanical ventilation were compared. Results:regardless of APACHE Ⅱ score, the duration of mechanical ventilation(MVD) in CBP group is much lower than non-CBP group(P<0.05). In APACHE Ⅱ <15 group, the mobility is zero. We shorten the time in-ICU and in-hospital by increasing the costs of medical treatment in CBP group. In APACHE Ⅱ 15 to 25,every item is lower in CBP group than non-CBP group. In APACHE Ⅱ>25, The mobility in two groups was not different significantly(P>0.05). but the costs in-hospital, the timein-hospital is higher in CBP group than non-CBP-group.Conclusion: APACHE Ⅱ 15 to 25 is a optimal opportunity of SAP treated with CBP. The patient without financial pressures whose APACHE Ⅱ <15 also can choose the CBP to reduce the times-in-ICU. APACHE Ⅱ is helpfulto choose a opportunity for us to use CBP to treat SAP.
【Key words】APACHEⅡ;CBP;SAP
重症急性胰腺炎(severe acute pancreatitis, SAP)是一种相当凶险的急腹症 ......
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