摘要
目的探讨急性生理与慢性健康评分(acute physiology and chronic health evaluationⅡ,APACHEⅡ)分层与谵妄的关系。方法对纳入研究的921例患者按有无谵妄发生分为两组(谵妄组,无谵妄组),并对两组患者进行入ICU最初24 h内的APACHEⅡ评分,按重症医学专业医疗质量控制指标信息自动化收集方法,并按照标准<10分,10~15分,16~20分,21~25分,>25分对APACHEⅡ评分进行分层。对比不同APACHE分层之间的患者谵妄发生的差异性,并进一步对比不同APACHEⅡ分层之间谵妄亚型的分布差异性。结果两组患者在不同APACHEⅡ分层之间谵妄发生率分布有差异性,卡方检验Pearson卡方值13.521,P=0.009,其中APACHEⅡ16~20分谵妄发生率最高,达37.9%;两组患者在不同APACHEⅡ分层之间谵妄亚型分布也有差异性,卡方检验Pearson卡方值22.208,P=0.035,34%的活动减少型谵妄患者分布在APACHEⅡ>25分这个层次中。总体上,发生谵妄的患者在APACHEⅡ21~25分层次占比最高,占比为26.4%。结论不同APACHEⅡ分层之间的患者谵妄发生率不同,谵妄亚型的分布也不同,认识急性生理与慢性健康评分分层与谵妄的关系对临床诊治谵妄有重要意义。
Objective To explore the relationship between the stratification of acute physiology and chronic health evaluation II （APACHE II ） and delirium.Methods 921 patients in the study were divided into two groups according to the occurrence of delirium.Data from patients in the first 24 hours of their admission to ICU were collected and scored with APACHE II by the method of automatic collection of quality control index information.The APACHE II scores were stratified according to the standard APACHE II 〈10 scores, 10- 15 scores, 16- 20 scores,21 - 25 scores and 〉 25 scores.The differences of patients with different levels of delirium and the differences in the distribution of different subtypes of delirium were compared.Results There was a difference in the occurrence of delirium among patients with different levels in the two groups.In Chi square test,the value of Pearson was 13.521 with P= 0.009.The highest occurrence of delirium was 37.9% when the score of APACHE II was 16- 20.The distribution of subtypes of delirium was also different between the two groups at different levels.In Chi square test, the Pearson val- ue was 22.208 with P=0.035.34% of hyperactive patients with delirium appeared when the score of PACHE II was above 〉 25. Overall , the proportion of patients with delirium at this level（APACHE lI 21 -25 scorse） was the highest, accounting for 26.4%.Conclusion There was a difference in the incidence of delirium among patients with different levels of APACHE II .The distribution of subtypes of delirium was also different at different levels.Understanding the relationship between acute physiology and chronic health score and delirium is of great significance in clinical diagnosis and treatment of delirium.
出处
《中国疗养医学》
2017年第10期1015-1018,共4页
Chinese Journal of Convalescent Medicine
基金
四川省医学会重症医学(新晨)专项课题(2015ZZ002)
关键词
急性生理与慢性健康评分
谵妄
分层
Acute physiology and chronic health evaluation
Delirium
Stratification
