摘要
目的研究中毒严重度评分(PSS)与APACHEⅡ评分在评估阿维菌素中毒患者病情及预后中的价值。方法选取本院急诊科2009年1月～2011年12月收治的119例急性阿维菌素中毒患者,入院后24h内完成相关数据采集,4周后为观测终点,预后作为观察指标。比较两种方法对阿维菌素中毒患者病情及预后判断的敏感性、特异性。结果以死亡作为观察指标时,两种评分方法均显示高危组死亡率大于中、低危组,差异有统计学意义(P<0.05):PSS低、中、高危组分别为0、10.4%、66.7%,APACHEⅡ评分低、中、高危组分别为0、33.3%、75.0%。两种评分方法判断阿维菌素中毒预后的敏感性分别为70.5%、88.2%,特异性分别为94.1%、97.0%,阳性预测值分别为66.7%、75.1%,阴性预测值分别为95%、98%。结论 PSS及APACHEⅡ评分对阿维菌素中毒患者的预后具有同等预测价值。两种方法的特异性、阴性预测值均高,都能正确挑选出非高危患者。APACHEⅡ评分敏感性较高,如果应用其评分后的患者为"高危",则必须给予足够重视,需对其进行加强治疗和监护,且评分方法相对更复杂,适合监护病房使用。PSS评分敏感性相对低,且评分方法结构简单,对于预测为"非高危"者可以认为预后良好,适合阿维菌素中毒患者在门急诊、留观病房的筛查。
Objective To study the valuation of PSS and APACHEⅡscore in assessment of condition and prognosis in patients with avermectin poisoning.Methods 119 cases which were suspected of having avermectin poisoning were chosen from the ICU of emergency department in our hospital from January 2009 to December 2011.Finish related data collection,within 24 h after admission to complete relevant data collection,after 4 weeks as the observation of the finish,the prognosis as the outcome,two methods of abamectin poisoning patients and prognosis judgment of sensitivity and specificity were compared.Results In death as observing indexes,the two score systems showed that the mortality of the low-risk or moderate-risk group was significantly lower than high-risk group（P＆lt;0.05）：PSS low,medium and high risk group of 0,10.4%,66.7%,respectively;APACHE Ⅱ score low,medium and high risk group of 0,33.3%,75.0% respectively.Two methods of grading that estimate the prognosis of abamectin poisoning sensitivity was 70.5%,88.2%,respectively;Specificity of 94.1%,97.0% respectively;Positive predictive value was 66.7% and 75.1%,respectively;Negative predictive value was 95%,98% respectively.Conclusion PSS and APACHEⅡ score for the prognosis of patients with avermectin poisoning are equally predictive value.Specificity of the two methods,negative predictive value are high,means that are correctly selected the high-risk patients.APACHE Ⅱ score sensitivity is higher,if applied after the score of patients as ＂high risk＂,we must give the enough value,need to strengthen treatment and care,and scoring method is relatively more complex,suitable for care unit.PSS score sensitivity is relatively low,and the evaluation method is of simple structure,to predict patients as ＂non-high risk＂ can be thought of as prognosis is good,suitable for Avermectin poisoning patients of outpatient emergency care,under observation ward in screening.
出处
《中国当代医药》
2013年第23期24-26,共3页
China Modern Medicine
作者简介
张永强（1978-），男，主治医师，主要从事急诊内科各项急危重症抢救．尤其擅长各种中毒的抢救工作
通讯作者：但勇（1975-），男，主治医师，主要从事急诊内科各项急危重症抢救，尤其擅长心血管急诊的救治
