【摘要】 目的 应用急性生理学及慢性健康状况评分Ⅱ(acute physiology and chronic health evaluationⅡ，APACHEⅡ)系统评估急诊内科重症监护病房(intensive care unit,ICU)患者疾病的危重程度、疗效和预后。方法 观察内科急诊ICU共163例重症患者，进行3天动态APACHEⅡ评分及临床对比。结果 死亡47例，APACHEⅡ分值为(24.67±6.93)分；存活116例，APACHEⅡ分值为(15.8±7.33)分，两者差异有非常显著性(t＝4.65，P<0.01)。其中肺部感染组APACHEⅡ评分最高(25.44±8.46)分，与其他病种组存在组间差异(P<0.01)。脑血管疾病组病死率最高(37.93%)，其3天动态APACHEⅡ评分差异有显著性(P<0.05)。在第24h内脑血管疾病组的APACHEⅡ评分与心血管疾病组相比差异则无显著性，分别为(16.60±5.08)分和(16.09±8.20)分(t＝0.37，P>0.05)。预计病死率和实际病死率均与APACHEⅡ分值呈显著正相关。结论 APACHEⅡ评分系统可以较准确预测患者的感染严重性、治疗效果和预后。对于病情有变化且入院时一次性评分不能获得准确预测结果的患者进行动态评分，则更能准确地评估其预后。

    【关键词】 急性生理学及慢性健康状况评分Ⅱ；重症监护病房；预后

    Prediction of outcome by continual APACHEⅡscoring system for emergency internal patients in ICU

    TANG Yun, PAN Li-ping.

    Emergency Department of Jingan District Central Hospital, Shanghai 200040, China

    【Abstract】 Objective To evaluate the significance of the prediction of APACHEⅡscoring system for emergency internal patients in ICU.Methods 163 cases of emergency internal ICU were compared and studied. These data were evaluated with APACHEⅡscoring system for 3 days.Results The scores of the 47 nonsurvivors were significantly higher than those of 113 survivors (24.67±6.93 vs.15.8±7.33,t=4.65 ......