改良DECAF评分对AECOPD拒绝插管患者无创机械通气结局的评估

doi:10.3969/j.issn.1002-1949.2019.02.004

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摘要目的探讨改良DECAF评分对慢性阻塞性肺疾病急性加重期（acute exacerbation of chronic obstructive pulmonary disease， AECOPD）拒绝插管患者无创机械通气（NIV）结局的预测价值。方法采用前瞻性观察性研究方法，连续收集本院2016年8月至2018年2月收治的90例AECOPD拒绝插管并行NIV患者的临床资料，使用改良DECAF评分、DECAF评分、APACHEⅡ评分三种评分系统在入院24 h内对患者进行评分，入院后30 d患者生存状态为观察终点，使用受试者工作特征曲线下面积（AUC）评价三种评分预测患者预后的价值。结果三种评分系统AUC相互比较，改良DECAF评分［0.875 (95%CI0.805~0.945)］评估预后的AUC明显大于DECAF 评分［0.784 (95%CI0.681~0.887)］和APACHEⅡ评分［0.741 (95%CI 0.628~0.854）,P＜0.05］。结论改良DECAF评分预测AECOPD拒绝插管患者NIV结局的效能优于DECAF评分、APACHEⅡ评分。

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	石齐芳
	谢晓洪
	傅晓燕
	蔡金芳
	王树云
	盛鹰

关键词 ：慢性阻塞性肺疾病(COPD）, 呼吸衰竭, 无创机械通气, DECAF评分

基金资助:上海市浦东新区卫生系统重点学科建设资助（PWZxk2017-20）；上海市浦东医院浦秀计划项目资助（PX201607）

通讯作者: 盛鹰(1982-)，男，硕士，副主任医师，教研室秘书，科主任助理， E-mail：sweet191@sohu.com。

作者简介: 石齐芳（1987-），男，硕士， E-mail：shiqifang456@163.com。

引用本文:

石齐芳，谢晓洪，傅晓燕，蔡金芳，王树云，盛鹰. 改良DECAF评分对AECOPD拒绝插管患者无创机械通气结局的评估[J]. 中国急救医学, 2019, 39(2): 115-119.
Shi Qi-fang, Xie Xiao-hong, Fu Xiao-yan, Cai Jin-fang, Wang Shu-yun, Sheng Ying. Modified-DECAF score in the outcome evaluation of non-invasive ventilation in AECOPD patients with do-not-intubate order. Chinese Journal of Critical Care Medicine, 2019, 39(2): 115-119.

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http://www.cnemergency.org.cn/CN/10.3969/j.issn.1002-1949.2019.02.004 或 http://www.cnemergency.org.cn/CN/Y2019/V39/I2/115

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