摘要
目的分析在急性呼吸窘迫综合征患者病情严重程度及预后评估中应用重症超声的价值。方法回顾性分析2017年1月~2019年1月南方医科大学深圳医院(以下简称"我院")重症超声完成全程病情监控的急性呼吸窘迫综合征患者50例(重症超声评分监护组),根据预后情况划分为死亡组(15例),存活组(35例)。依照病情严重程度(氧合指数>200~300 mmHg为轻度,氧合指数>100~200 mmHg为中度,氧合指数≤100 mmHg为重度)分为轻度组(13例)、中度组(15例)、重度组(22例)。观察各组重症超声评分与患者急性生理学及慢性健康状况评分系统(APACHEⅡ)评分、序贯器官衰竭评分、氧合指数的相关性。另选我院同期急性呼吸窘迫综合征患者50例(常规监护组),比较不同监护方法下患者住院时间、机械通气时间、ICU时间、病死率、呼吸机撤离失败情况。结果死亡组与存活组呼吸机参数呼吸末正压比较,差异有统计学意义(P <0.05),死亡组重症超声评分显著高于生存组(P <0.05),重度组APACHEⅡ评分、序贯器官衰竭评分、重症超声评分评分高于轻、中度组(P <0.05),重症超声评分与APACHEⅡ评分、序贯器官衰竭评分呈正相关(r=0.641,P <0.01;r=0.523,P <0.01),与氧合指数呈负相关(r=-0.715,P <0.01)。与常规监护组比较,重症超声评分监护组住院时间更短,通气时间更短,ICU时间更短,病死率、撤机失败率、致残率更低,差异均有统计学意(均P <0.05)。结论在急性呼吸窘迫综合呼吸综合征患者临床病情监测中使用重症超声评分可对患者病情严重程度进行有效评估,具较高应用价值。
Objective To analyze the value of severe ultrasound in the evaluation of severity and prognosis of patients with acute respiratory distress syndrome.Methods The clinical data of 50(critical ultrasound score and care group)patients with acute respiratory distress syndrome(ARDS)who were monitored by ICU in Shenzhen Hospital Southern Medical University(hereinafter referred to as"our hospital")from January 2017 to January 2019 were analyzed retro spectively.According to the prognosis,the patients were divided into death group(15 cases)and survival group(35 cases).According to the severity of the disease(oxygenation index>200-300 mmHg is mild,oxygenation index>200-300 mmHg is moderate,and oxygenation index≤100 mmHg is severe),they were divided into light group(13 cases),medium group(15 cases)and heavy group(22 cases).The correlation between severe ultrasonic score and acute physiology and chronic health status scoring system(APACHEⅡ),sequential organ failure score,and oxygenation index was observed.Another 50 patients with acute respiratory distress syndrome admitted to our hospital during the same period were selected(routine care group),the hospital stay,mechanical ventilation time,ICU time,fatality rate and failure of ventilator evacuation were compared under different monitoring methods.Results The final positive pressure of ventilator parameters was compared between the death group and the survival group,and the difference was statistically significant(P<0.05),the critical ultrasound score of patients in the death group was significantly higher than that in the survival group(P<0.05),severe set of APACHEⅡ,sequential organ failure score and severe ultrasonic score were higher than mild and moderate groups(P<0.05).The severe ultrasonic score was positively correlated with APACHEⅡ,sequential organ failure score positive correlation(r=0.641,P<0.01;r=0.523,P<0.01),while negatively correlated with oxygenation index(r=-0.715,P<0.01).Compared with the conventional monitoring group,the hospital stay was shorter,the ventilation time was shorter,the ICU time was shorter,and the fatality rate,withdrawal failure rate of ventilator vacuation and disability rate of critical ultrasound score care group were lower,the differences were statistically significant(P<0.05).Conclusion The use of severe ultrasound score in the clinical condition monitoring of patients with acute respiratory distress syndrome can effectively evaluate the severity of the patients′condition,which has high application value.
作者
刘星
李晓雷
黄忠毅
李健球
LIU Xing;LI Xiaolei;HUANG Zhongyi;LI Jianqiu(Department of Emergency,Shenzhen Longhua District Central Hospital,Guangdong Province,Shenzhen 518110,China;Department of Emergency,Shenzhen Hospital Southern Medical University,Guangdong Province,Shenzhen 518101,China)
出处
《中国医药导报》
CAS
2020年第17期125-128,144,共5页
China Medical Herald
基金
广东省科技厅自筹经费类科技计划项目(20172C0051)。
关键词
重症超声评估
急性呼吸窘迫综合征
回顾性分析
相关性分析
病情严重程度及预后
Severe ultrasound evaluation
Acute respiratory distress syndrome
Retrospective analysis
Correlation analysis
Severity and prognosis
