本院重症医学科患者疾病构成及预后分析-东南大学学报医学版

本院重症医学科患者疾病构成及预后分析

单位：南京市市级机关医院ICU, 江苏南京 210018

分类号：R195.4

出版年·卷·期（页码）：2015·34·第二期（277-279）

摘要：

目的:探讨重症医学科患者的来源及疾病构成特点、预后分析,进而为临床诊治提供指导.方法:回顾分析本院2009年4月至2014年3月429例入住重症医学科患者的临床资料,分别收集性别、年龄段、病人来源、疾病构成及死亡组的主要疾病、APACHEⅡ评分等信息.结果:年龄≥65岁的老年患者占同期重症医学科住院患者的73.9%(317例).老年患者入院APACHEⅡ评分较年轻组显著增高(P <0.01).本组患者中男性多于女性,男248例,女181例,男女比例1.37∶1.其中来源于本院内科病房224例,急诊136例,外科术后60例,其他来源9例.位居疾病构成前三位的是脓毒症(215例)、脑卒中(71例)和心血管疾病(67例).患者转归以转回普通病房最多,为213例(49.6%),出院者148例(34.4%),死亡68例(15.8%).死亡患者APACHEⅡ评分较存活组显著增高(P <0.01),第一位死因为脓毒症(39例).结论:本院重症医学科患者以老年为主,男性较多,绝大部分来源于内科病房,脓毒症是首位死因,APACHEⅡ评分与预后相关.

Objective: To explore the source of cases, the admission reasons and the therapy effect in intensive care unit(ICU). Methods: Retrospective analyses were performed on critically ill patients who were hospitalized in the ICU with age, sex and APACHE Ⅱ scores. 429 cases were selected and their spectrum of disease were analysed. Results:Older patients accounted for 73.9% of the ICU hospitalized patients, the APACHE Ⅱ score of old group was significantly higher than that of younger ages (P< 0.01). It consisted of 248 men and 181 women, the ratio of men to women was 1.37∶1. The source of cases included:224 cases (52.5%) in group transferred from medical ward, 136 cases (31.6%) in group transferred from emergency, and 60 cases (13.9%) from post-operation. According to their admission reasons, the proportion ratio in order respectively was sepsis (50.1%), stroke(16.5%), cardiovascular disease(15.6%). The outcome included: back to the general ward (49.6%), discharge (34.4%), death(15.8%). The APACHE Ⅱ score of death group was significantly higher than that of the survival group (P <0.01). The first cause of death was sepsis (39 cases). Conclusion: In our ICU, the source of cases is mainly from medical ward, sepsis is the leading cause of death. APACHE Ⅱ score could predict prognosis in ICU patients.

参考文献：

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