摘要
目的 应用APACHEⅡ连续评分判断重症胰腺炎的严重性、预后和并发症 ,决定手术和再次手术时机。方法 重症胰腺炎 31例中 ,急诊手术 2 5例 ,其中单次手术 14例 ,多次手术 11例 ,非手术 6例。采用APACHEⅡ连续评分 ,间隔 2 4～ 48h评分 1次。死亡组与非死亡组连续评分比较 ,手术组与非手术组连续评分比较 ,单次手术组与多次手术组连续评分比较。结果 连续评分逐日上升或居高不下是预后恶劣的重要信号 ,连续评分陡升说明发生并发症。结论 连续APACHEⅡ评分对于判断重症胰腺炎的严重性和预后优于单次评分。单次评分不能预测并发症的发生 ,而连续评分可从其连续趋势上预知是否有重大并发症发生。并可据此决定手术适应证和再次手术适应证。
Objective To investigate the dynamic APACHE Ⅱ scoring used for assessing the severity,prognosis and morbidity of patients with severe acute pancreatitis(SAP) and for decision of operative intervention.Methods 31 cases with SAP were admitted in our department.Operations were performed in 25 cases,among whom multiple operations were done in 11 cases and single-operation in 14.The other 6 cases received no operation.APACHE Ⅱ scoring was obtained during admission and sequentially then at interval of 24～48hrs.Comparisons of the APACHE Ⅱ scoring between survivals and nonsurvivals,patients with operative interference and conservative therapy,with unioperation and multioperation performed, were undertaken.Results Dynamic APACHE Ⅱ scoring of patients elevating steadily or abruptly revealed a poor prognosis or emerging severe complications.Conclusion Our finding of the dynamic scoring among patients with SAP shows that sequential evaluating APACHE Ⅱ scoring demonstrates a better prediction of prognosis and survival for patients with SAP.It can also be used as the indicator of surgical interventions.
出处
《中国实用外科杂志》
CSCD
北大核心
2000年第11期655-657,共3页
Chinese Journal of Practical Surgery
