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目的:探讨应用急性生理和慢性健康状况评分Ⅱ(APACHEⅡ)评估急性有机磷农药中毒(AOPP)患者行气管插管时机的临床意义。方法:回顾性分析我院AOPP患者122例,分别计算APACHEⅡ评分值,进行验证,Logistic回归分析,建立回归模型。结果:122例患者行气管插管56例,APACHEⅡ评分3~36分,气管插管组(19.93±7.34)分,气管未插管组(10.33±4.90)分,2组比较差异有统计学意义(t=5.18,P=0.000)。进行Logistic回归分析后得到气管插管风险模型。结论:APACHEⅡ系统应用于AOPP患者行气管插管时机的评估有一定的临床指导意义,APACHEⅡ评分值越高,插管概率越高。当APACHEⅡ评分≥15分时需加强对AOPP患者呼吸情况监测;当APACHEⅡ评分值≥24分时,早期予以保护性气管插管,患者可能获益更大。
Objective: To investigate the clinical significance of assessing the timing of tracheal intubation with acute physiology and chronic health score Ⅱ (APACHE Ⅱ) in patients with acute organophosphorus pesticide poisoning (AOPP). Methods: A retrospective analysis of 122 patients with AOPP in our hospital, were calculated APACHE Ⅱ score, validation, Logistic regression analysis, the establishment of regression model. Results: There were 56 cases of tracheal intubation, 3 to 36 points for APACHEⅡ, 19.93 ± 7.34 for endotracheal intubation group, and 10.33 ± 4.90 for endotracheal intubation group. The difference between the two groups was statistically significant (t = 5.18, P = 0.000). Tracheal intubation risk model was obtained after Logistic regression analysis. Conclusion: APACHE Ⅱ system used in AOPP patients tracheal intubation timing assessment of a certain clinical significance, the higher the APACHE Ⅱ score, the higher the probability of intubation. When the APACHE Ⅱ score ≥ 15 points need to strengthen the respiratory monitoring of patients with AOPP; when the APACHE Ⅱ score ≥ 24 points, early protection of the tracheal intubation, the patient may benefit more.