The Significance Of APACHE-? Score In Evaluating The Severity Of Neurovenomous Snake Bites

Objective:The clinical data of neurovenomous snake bite patients within24 hours before admission were collected and retrospectively analyzed.And this study mainly to explore the significance of APACHE-II score in assessing the severity of nerve snake bite.Method:Through the HIS system and archives of the First Affiliated Hospital of Guangxi Medical University,we searched and reviewed the patients diagnosed with nerve snake bites in the emergency room and the intensive care unit and intensive care unit of our hospital from January 2010 to January 2019.The patient's clinical data were collected and collected,including general conditions such as age,gender,and vital signs;the worst clinical indicators within 24 hours of admission:APACHE-II score,GCS score,white blood cell count,neutrophil percentage,C response Protein,electrolyte,total bilirubin,direct bilirubin,serum albumin,blood lactate level,pH value,oxygen partial pressure,creatinine clearance rate,coagulation function index,hospitalization time,etc.Statistical methods were used to analyze the significance of APACHE-II scores in assessing the severity of neurotic snake bites.Results:1.This study includes 77 patients,clinical data,which including 63males and 14 females.And the occupation was dominated by farmers,which accounting for 80%.The average age was?40.25±15.34?years,mean length of stay was?6.51±4.89?days.According bite"2018 China snakebite treatment expert consensus"snake severity score,serious snakebite patients were 25 cases,accounting for 23.5%;non-serious snakebite patients were 52 cases,accounting for 67.5%.2.This study showed that APACHE II score and GCS score,blood lactic acid level,oxygen partial pressure,PH value,creatinine clearance rate and other indicators were related to the severity of nerve snake bite,and there were statistically significant differences among patients with different severity of nerve snake bite?p<0.05?.3.In this study 77 patients overall probability of occurrence of pneumonia and respiratory failure was 44.15 percent,14.28 percent,respectively;the bite patients probability pneumonia and respiratory failure was 72.0%,28.0%respectively,with severe neurological snakes,non-serious neurological snakebite probability of pneumonia was 30.8%probability of respiratory failure was 7.7%.4.After logistic regression analysis,neural APACHE-II score was independent risk factor for snake bites,and statistically significant?p<0.05?difference between the severe patients with non-severe neurological snakes.5.APACHE-II score>15.5 points and SSS score>7.5 points snake bites in severe nerve area under the ROC curve was 0.815 and 0.856,respectively,both of similar values,and the difference in area under each curve were statistically significant?p<0.001?.Conclusions:1.Snakebite patients with severe neurological symptoms appear early,in critical condition,early assessment of the disease and timely treatment is the key to treatment.2.Apache-ii score,GCS score,Lac,PaO₂,Ccr and other indicators are of guiding significance for the evaluation of the severity of nerve snake bite.3.APACHE-II score>15.5 points and SSS score>7.5 points,the assessment ability of the patients with severe nerve snake bite was basically consistent.