摘要
目的根据孕产妇妊娠期生理、病理变化的特点,建立产科危重症患者病情评估系统。方法回顾性分析2000年1月至2008年7月广州医学院第三附属医院孕产妇救治中心救治的311例危重症孕产妇临床资料,以死亡为病情严重的最终结局将患者分为生存组(239例)和死亡组(72例);选出与死亡相关的临床生理指标作为系统参数并进行赋值,参考急性生理和慢性健康状况评分系统(APACHE),建立产科危重症患者病情评估系统;筛选指标采用t检验,产科危重症病情评估系统死亡风险预测公式采用logistic回归分析。结果建立的产科危重症病情评估系统由18个参数组成,包括体温、平均动脉压、呼吸频率、心率、氧合指数、pH值、钠离子浓度、钾离子浓度、血糖、血清肌酐、血清总胆红素、白蛋白、丙氨酸氨基转移酶、血小板计数、血浆纤维蛋白原、白细胞计数、血细胞比容和格拉斯哥昏迷评分(GCS)。死亡风险预测公式为:log eY/(1-Y)=-7.275+0.245×总评分。结论初步建立了产科危重症病情评估系统,以利于提高危重症孕产妇的病情评估。
Objective To establish a prediction system for the critically ill obstetric patients. Methods A retrospective study was conducted in 311 critically ill obstetric patients, who were admitted to the ICU of the Third Affiliated Hospital of Guangzhou Medical University from January 2000 to July 2008. The patients were divided into dead group（72 patients） and survival group （239 patients）. Assigned the clinical indexes related to the mortality and established a prediction system for the critically ill obstetric patients. The clinical indexes were analyzed by using t test and the mortality prediction equation by using logistic regression model. Results The prediction system involved 18 clinical indexes, including body temperature, mean artery pressure, respiratory rate, heart rate, PaOJFiO2 , arterial pH, serum sodium, serum potassium, blood glucose, serum creatinine, serum total bilirubin, serum albumin, ALT, blood platelet count, fibrinogen, white blood count, hematocrit and scores of nervous system. The prediction equation for the mortality risk： log eY/（1 -Y） = -7.275 ＋ 0.245 × total scores. Conclusions Establishing a prediction system for the critically ill obstetric patients not only improves the diagnostic level but also has an scientific and objective basis in improving medical quality and utilizing the medical resources.
出处
《中华产科急救电子杂志》
2013年第2期42-47,共6页
Chinese Journal of Obstetric Emergency（Electronic Edition）
基金
广东省科技计划项目(2012B031800335)
关键词
妊娠
高危
疾病严重程度指数
预测
病情评估
Pregnancy, high-risk
Severity of illness index
Forecasting
Evaluation
