摘要
目的:探讨APACHEⅡ评分、P(A-a)O_(2)、PaO_(2)/FiO_(2)与血乳酸清除率对呼吸衰竭患者预后的评估价值。方法:回顾性分析2019年4月-2021年2月于沭阳医院接受诊治的81例呼吸衰竭患者的临床资料,其中包括52例存活患者(纳入存活组)及29例死亡患者(纳入死亡组)。比较两组急性生理与慢性健康评分(APACHEⅡ)、动脉氧分压与吸入氧浓度比(PaO_(2)/FiO_(2))、肺泡-动脉血氧分压差[P(A-a)O_(2)]及血乳酸清除率。结果:进入重症监护室时,两组APACHEⅡ评分、PaO_(2)/FiO_(2)、P(A-a)O_(2)比较,差异均无统计学意义(P>0.05)。进入重症监护室6、12、24、48、72 h,存活组APACHEⅡ评分、P(A-a)O_(2)均低于死亡组,PaO_(2)/FiO_(2)、血乳酸清除率均高于死亡组(P<0.05)。ROC曲线面积统计结果显示,APACHEⅡ评分、PaO_(2)/FiO_(2)、P(A-a)O_(2)、血乳酸清除率ROC曲线面积分别为0.942、0.979、0.944、0.794;敏感度分别为0.894、0.897、0.873、0.742;特异度分别为0.894、0.915、0.875、0.801。结论:针对呼吸衰竭患者通过APACHEⅡ评分、PaO_(2)/FiO_(2)、P(A-a)O_(2)及血乳酸清除率实施预后评估,能够具有突出的临床应用价值,因此适合进一步深入研究和普及。
Objective:To investigate the prognostic value of APACHEⅡscore,P(A-a)O_(2),PaO_(2)/FiO_(2)and blood lactate clearance rate in patients with respiratory failure.Method:The clinical data of 81 patients with respiratory failure treated in Shuyang Hospital from April 2019 to February 2021 were retrospectively analyzed,including 52 patients who survived(included in the survival group)and 29 patients who died(included in the death group).Acute physiology and chronic health evaluation(APACHEⅡ),partial pressure of oxygen/inhaled oxygen concentration(PaO_(2)/FiO_(2)),P(A-a)O_(2)and blood lactate clearance rate were compared between the two groups.Result:There were no significant differences in APACHEⅡscore,PaO_(2)/FiO_(2),P(A-a)O_(2)between the two groups at admission to the intensive care unit(P>0.05).At 6,12,24,48,and 72 h after admission to the intensive care unit,the APACHEⅡscore and P(A-a)O_(2)in the survival group were lower than those in the death group,the PaO_(2)/FiO_(2)and blood lactate clearance rate in the survival group were higher than those in the death group(P<0.05).The ROC curve area statistics showed that the ROC curve areas of APACHEⅡscore,PaO_(2)/FiO_(2),P(A-a)O_(2)and lactate clearance rate were 0.942,0.979,0.944 and 0.794,respectively,the sensitivities were 0.894,0.897,0.873 and 0.742,respectively,the specificity were 0.894,0.915,0.875 and 0.801,respectively.Conclusion:The prognostic evaluation of patients with respiratory failure through APACHEⅡscore,PaO_(2)/FiO_(2),P(A-a)O_(2)and blood lactic acid clearance rate can have outstanding clinical application value,so it is suitable for further in-depth research and popularization.
作者
石小坚
顾媛媛
赵永娟
SHI Xiaojian;GU Yuanyuan;ZHAO Yongjuan(Shuyang Hospital,Jiangsu Province,Shuyang 223600,China;不详)
出处
《中国医学创新》
CAS
2022年第29期105-109,共5页
Medical Innovation of China
关键词
呼吸衰竭
急性生理与慢性健康评分
血乳酸清除率
Respiratory failure
Acute physiology and chronic health evaluation
Blood lactate clearance
