改良产科危重症评分系统的建立与应用-妇产科学专业论文.docxVIP

PAGE PAGE 8 the APACHE Ⅱsystem and the APACHE Ⅲ system of the parameters. 3. The application of the improved evaluation system for the critically ill obstetric patients: ①The scores depending on the the improved evaluation system were calculated. ②To compare the score differences between the survivors and non-survivors groups.Do the ROC curve of APACHEⅡsystem and the modified scoring system to find the cut-off point. ③ The relationship between the score and the maternal outcomes(organ dysfunction and prognosis) were analyzed. Result: The improved evaluation system for the critically ill obstetric patients system involves 15 physiologic variables include: Body temperature, Mean arterial pressure, Respiratoryrate, Heartrate, SaO2, Serum creatinine, Bilirubin total, Bloodglucose concentration, Serum albumin, ALT transaminas, Blood platelets count, fibrinogen, White blood count, Hematocrit, Systema nervosum,Serum potassium. The relative weights of each variable(0-4)were assigned and the maximum total score is 56. A signlficant difference was found between survivors and non-survivors groups on the score of patients scored by the improved evaluation system for the critically ill obstetric patients respectively(P＜0.05).The score of the survivors is 8.33± 5.74,whereas the non-survivors is 17.93±5.00. The c-index for APACHE Ⅱ(0.859) is smaller than for the improved evaluation system in critically ill obstetric patients(0.914).With the score increased, the rate of the maternal organ dysfunction is increasing. and they are significantly positively correlated（b=0.784）. 2 organ dysfunction ： Score 9 sub-division,compared with 0-8 significant difference(P=0.031)；3 organ dysfunction：Score 14 sub-division,compared with 0-13 significant difference(P=0.043). There are significant differences of charges and the days in ICU in defferent groups. Conclusion： The improved evaluation system for the critically ill obstetric patients composed of 15 physiological