探讨重症监护评分与脓毒症相关性脑病诊断及预后的意义.docVIP

精品论文 参考文献 探讨重症监护评分与脓毒症相关性脑病诊断及预后的意义 李敏雄 柯媛媛 伍增龙 马 俊 　　广东省佛山市高明区人民医院重症监护科 广东佛山 528500 　　【摘 要】目的：评估ICU意识状态评分（CAM-ICU）对脓毒症相关性脑病（SAE）的诊断作用，及其与SAE预后的关系。方法：选取入住ICU超过24 h的脓毒症患者， 1 d 2次进行CAM-ICU评分。根据CAM-ICU评分，将患者分为SAE组和无SAE组，观察2组患者的临床特征、平均住院日、住院期间死亡率。结果：共入选56例脓毒症患者，根据CAM-ICU评分，15例（26.8%）患者被诊断为SAE，SAE患者年龄大于非SAE患者,为（64.2plusmn;7.1）岁VS （56.6plusmn;6.5）岁, P lt;0.001；使用镇静药及抗精神病药的比例高于非SAE者（分别为60% VS 24.4%,P=0.01；40% VS 7.3%,P=0.01）。但2组性别、APACHEII评分、机械通气使用率无统计学差异（P gt;0.05）。SAE组平均住院日及住院期间死亡率均高于非SAE组，分别为（15.9plusmn;9.1）VS（11.2plusmn;7.4）,P=0.03;33.3% VS 4.9%,P=0.02。采用生存曲线分析显示，SAE组的预后差于非SAE组（x2=9.621，P =0.002）。结论：CAM-ICU评分有助于对SAE患者的诊断，高龄、使用镇静药、抗精神病药可能会增加SAE的风险，SAE患者预后相对非SAE患者差。 　　【关键词】意识状态评分；脓毒症相关性脑病；脓毒症；预后 　　【中图分类号】R714.62+6 【文献标识码】B 【文章编号】1674-8999（2015）9-0689-02 　　Evaluation of CAM-ICU for the detection of Sepsis-Associated Encephalopathy in sepsis patients focusing on relevant clinical outcomes 　　Li Minxiong,Ke Yuanyuan,Wu Zenglong,Ma Jun 　　(Intensive Care Unit,Gaoming Peoplersquo;s Hospital,Foshan,Guangdong,528500,China) 　　【Abstract】Purpose: To assess the value in the diagnosis of Sepsis-Associated Encephalopathy(SAE) obtained by the Confusion Assessment Method for the ICU(CAM-ICU) and the association with outcomes. Methods: Sepsis patients admitted to the ICU for more than 24 hours were included. All the patients were evaluated twice a day by the CAM-ICU , and were divided into SAE group and non-SAE group. Clinical features , length of hospital stay and hospital mortality were compared between the two groups. Results: During the study period ,56 patients were evaluated, SAE was identified in 26.8% of patients by CAM-ICU. Patients with a diagnosis of SAE were older（64.2plusmn;7.1 VS 56.6plusmn;6.5,Plt;0.001）.Frequency of SAE was higher in patients receiving sedatives and antipsychotics（60% VS 24.4%,P=0.01;40% VS 7.3%,P=0.01）.No significant differences between those with and without SAE regarding sex, Acute Physiology and Chronic Health Evaluation (APACHE) II, or