生命体征及综合评分在预测热射病患者预后中的价值分析

目的探讨热射病患者入院时生命体征及综合评分在预测临床预后中的价值。 方法收集西部战区总医院2012年1月至2018年12月收治入院的34例热射病患者临床资料，根据预后情况分为存活组与死亡组，回顾性分析两组患者临床资料，评价患者入院时生命体征及综合评分在判断该病预后中的临床价值。 结果34例患者中，29例患者好转出院，5例患者死亡，死亡率为14.71%(5/34)，死亡组及存活组中多器官功能障碍综合征(MODS)发生率依次为100%及55.17%(16/29)；死亡组患者平均年龄、入院时呼吸频率、心率及APACHE Ⅱ评分均高于存活组(P<0.05)，GCS评分低于存活组(P＝0.014)；死亡组患者总住院时间及ICU时间长于存活组(P<0.05)，且呼吸衰竭和酸碱平衡紊乱发生率及呼吸机使用率均高于存活组(P< 0.05)，但两组患者入院时体温及平均动脉压差异无统计学意义(P>0.05)。此外，入院时心率、APACHE Ⅱ评分及GCS评分在预测热射病患者死亡中的ROC曲线下面积均大于0.9，入院时呼吸频率、体温及平均动脉压在ROC曲线下面积依次为0.735、0.797及0.614。 结论热射病患者入院时心率、APACHEⅡ评分及GCS评分在预测临床预后中具有较高诊断价值，呼吸频率、体温在预测临床预后中具有中等诊断价值。

Value analysis on vital signs and comprehensive scores in predicting prognosis of patients with thermoplegia

Objective To assess the values of vital signs and comprehensive scores in predicting the prognosis of the patients with thermoplegia.Methods The clinical data of 34 patients who were hospitalized and diagnosed as thermoplegia in our hospital from January 2012 to December 2018 were retrospectively studied.The patients were divided into a survival group and a death group according to their prognosis,and the clinical data of the two groups were analyzed to assess the value of each index in predicting the prognosis of thermoplegia.Results Among the 34 patients,29 were discharged after improvement and 5 died,with the mortality rate of 14.71%(5/34).Furthermore,the incidence of multiple organ dysfunction syndrome(MODS)in the death group was 100%,while it was 55.17%(16/29)in the survival group.The average age and the respiratory rate,heart rate and APACHEⅡscore on admission in the death group were higher than those of the survival group(P<0.05).However,the GCS score of the death group was lower than that of the survival group(P=0.014).Moreover,the total length of stay in the hospital and in the ICU of the death group was longer than that of the survival group(P<0.05).However,the average body temperature and the arterial pressure of the two groups had no statistical significant difference(P>0.05).More importantly,the areas under the ROC curves of the heart rate,APACHEⅡscore and GCS score were greater than 0.9 in predicting the death of the patients with thermoplegia,while the areas under the ROC curves of the respiratory rate,temperature and arterial pressure were 0.735,0.797 and 0.614,respectively.Conclusion Heart rate,APACHEⅡscore and GCS score can be adopted as the clinical prognostic indicators for the patients with thermoplegia.