APACHEⅡ评分联合血小板对严重多发伤患者预后评估的研究.docVIP

APACHE II评分联合血小板对严重多发伤患者预后评估的研 宄 (南方医科大学附属云浮医院重症医学科527300) 目的探讨急性生理学及慢性健康评分II (APACHE II)联合血小板 评估严重多发伤患者的病情及预后。方法收集2011年6月至2014年2月期 间我院重症医学科收治的ISS (损伤严重程度评分)评分gt;16分的严重多发伤 患者86例。每天进行血小板测定及进行APACHE II评分。根据预后分为死亡组 和存活组，比较两组屮APACHE II评分、血小板差异，分析血小板、APACHE II评 分的相关性。结果存活组APACHE II评分明显低于死亡组(plt;0.05)，而血小板 明显高于死亡组(plt;0.05); APCHEII评分越高，血小板越低。结论APACHE II 评分联合血小板能比较准确地反映严重多发伤患者的病情及预后。 关键词：急性生理和慢性健康评分II;血小板；多发伤；预后 Study of APACHE II score combined with platelet counts on the prognosis of severe multiple trauma patients MO Bi-hua ,YE Jin, QUAN Xue-liang, CHENWei-ming, WAN Song, CHEN Shao-wu, CHEN Zhi-he Abstract Objective To investigate the significance of acute physiology and chronic health evaluation ll(APACHE ll)score and platelet counts in severityassessment and the prognosis prediction of severe multiple trauma patients. Methods 86 cases of severe multiple trauma from June 2011 to February 2014 withthe ISS score over 16 were enrolled in this retrospective study.AII the cases treated in ICU were divided into death group and survival group according to theprognosis. Platelet counts and APACHE II scoring were performedevery day during hospital stay, then comparing the platelet counts date with APACHE II scores, analysing the Correlativity between the two factors.ReduIts The APACHE II scores of survival group were significantly lower than the death group (plt;0.05), while the platelet counts of the survival group weresignificantly higher than the death group(plt;0.05); There was a negative correlativity between the APACHE II scores and platelet counts .Conclusion APACHE II scorecombined with platelet counts can correctly indicate the severity and prognosis of severe multiple trauma patients. Key words APACHE II scores; platelet counts ; severe multiple trauma ; prognosis. 严重多发伤伤情十分严重，病情进展快，并发症多，死亡率高。故如何 正确地评估病情的严重程度，从而及吋调整治疗手段是提高抢救成功率的一个重 要手段，也是指导ICU资源的配置和利用的关键。急性生理与慢性健康II (acute physiology andchronic health evaluation, APACHE II )评分系统是目前在国内外临 床上疲用最广泛、最权威的危重患者病情评价系统［1］