论文部分内容阅读
目的对比分析床边指数(BISAP)、急性生理和慢性健康评估(APACHEII)及Ranson评分对急性胰腺炎(AP)预后的预测价值。方法以广西医科大学第三附属医院收治的58例AP患者为研究对象,所有患者入院后及时行BISAP、APACHEⅡ及Ranson评分,比较三种评分标准对急性胰腺炎严重程度及预后预测价值。结果轻度、重度AP患者BISAP评分[(1.48±0.76)vs(2.72±1.81)]分、APACHEⅡ评分[(2.82±2.18)vs(10.71±2.87)]分、Ranson评分[(1.68±0.35)vs(4.56±2.32)]分比较差异有统计学意义(P<0.001)。58例AP患者中预后不良8例,预后良好50例,两组三种评分比较差异显著(P<0.05)。BISAP评分对AP严重程度、持续器官功能不全、死亡预测敏感度分别为0.76、0.65、0.64;APACHEⅡ评分对AP严重程度、持续器官功能不全、死亡患者预测敏感度分别为0.72、0.78、0.94;Ranson评分对AP严重程度、持续器官功能不全、死亡患者预测敏感度分别为0.70、0.71、0.72。结论三种评分标准在预测AP严重程度上类似,但在持续器官功能不全、死亡上APACHEⅡ评分预测价值最大,临床根据患者情况合理使用。
Objective To compare the predictive value of bedside index (BISAP), acute physiology and chronic health assessment (APACHEII) and Ranson score in the prognosis of acute pancreatitis (AP). Methods Fifty-eight patients with AP admitted to the Third Affiliated Hospital of Guangxi Medical University were enrolled in this study. All patients were given BISAP, APACHEⅡ and Ranson scores immediately after admission. The severity and prognosis of acute pancreatitis were compared among the three criteria. Results The BISAP score [(1.48 ± 0.76) vs (2.72 ± 1.81) vs APACHEⅡ score [(2.82 ± 2.18) vs (10.71 ± 2.87)], Ranson score [(1.68 ± 0.35) vs (4.56 ± 2.32)] points, the difference was statistically significant (P <0.001). 58 cases of AP patients with poor prognosis in 8 cases, good prognosis in 50 cases, two groups of three scores were significantly different (P <0.05). The sensitivities of BISAP score to AP severity, persistent organ dysfunction and death prediction were 0.76, 0.65, 0.64 respectively. The sensitivity of APACHEⅡscore to AP severity, persistent organ dysfunction and death patients were 0.72, 0.78, 0.94, respectively. Ranson Scores against AP severity, persistent organ dysfunction, and predicted death patients were 0.70, 0.71, 0.72, respectively. Conclusions The three scoring criteria are similar in predicting the severity of AP. However, APACHE II score is the most predictive value in patients with persistent organ dysfunction and death, and is reasonably used clinically according to the patient’s condition.