外科重症监测治疗课件.ppt

ICU-英文*ICU-英文*SAPS—SimplifiedAcutePhysiologyScore17variablesTheSAPSIIscore,usedmorefrequentlyinEurope,wasderivedinamannersimilartotheAPACHEscores.LeGallreducedformer34-variableAPACHEscoreto14parametersThisscoreisnotdiseasespecificbutratherincorporatesthreeunderlyingdiseasevariables(AIDS,metastaticcancer,andhematologicmalignancy).专科评分神经系统Glasgowcomascore(GCS)*心脏功能Goldman肝硬化Child-Turcotte烧伤指数ICU-英文*ICU-英文*ICU-英文*MPM—MortlityprobabilitymodelMPM-Ⅰ1985MPM-Ⅱ1993MPM0，MPM24，MPM48TheMPMcanbeusedtocalculateadirectprobabilityofdeathinpatientsadmittedtotheICUSeverity-of-illnessscoringsystemssufferfromtheproblemofinabilitytopredictsurvivalinindividualpatients.Thesetoolsshouldbeusedasimportantdatatocomplementclinicalbedsidedecision-making.ICU-英文*MPM(MortalityPredictionModels)DevelopedbyStanleyLemeshowUsesdatacollectedduringfirsthourofICUadmission;24hours;72hoursSeriesoftrue/falsequestionsWeightedaccordingtotheirindividualcontributiontomortalityICU-英文*MonitoringofRespiratoryfunction床旁观察既简单又实用。general:ConsciousnessRespiratorymovements，Respiratoryrate、apnea呼吸音。mucousICU-英文*呼吸运动的观察呼吸频率(RR)AdultRR10-18beat/min每分钟肺泡通气量(minuteventilation,MVMV)=[tidalvolume(VT)－deadvolume(VD)]×RRICU-英文*呼吸功能测定肺容量监测—反映静态通气功能潮气量(tidalvolume,VT)补吸气量(inspiratoryreservevolume,IRV)深吸气量(inspiratorycapacity,IC)补呼气量(expiratoryreservevolume,ERV)残气量(residualvolume,RV)功能残气量(functionalresidualcapacity,FRC)肺活量(vitalcapacity,VC)肺总量(totallungcapacity,TLC)Normal---80%predictedvalueICU-英文*Oxygentherapy氧治疗Oxygentherapyistheadministrationofoxygenasamedicalintervention,whichcanbeforavarietyofpurposesinbothchronicandacutepatientcare.氧治疗是通过吸入不同浓度的氧，使吸入氧浓度(F1O2)和肺泡气的氧分压(PAO2)升高，以升高动脉血氧分压(PaO2)，达到缓解或纠正低氧血症的目的