改良早期预警评分结合心电图、休克指数、血氧饱和度对评估急诊患者病情危重程度的价值  

Value of Modified Early Warning Score Combined with Electrocardiogram,Shock Index and Blood Oxygen Saturation in the Assessment of Diseases Severity among Emergency Patients

作　　者：麦泉云[1] 赵开亮[1] 张凤莲[1] 杨新疆[1] 曾宇[1] 符兆亮[1] 罗文意[1] 韦谱新[1] 周明明[1] 欧阳后华[1] 吴家栋[1] 

机构地区：[1]广西钦州市第二人民医院,钦州市535000

出　　处：《广西医学》2012年第10期1305-1308,共4页Guangxi Medical Journal

基　　金：广西医药卫生科研课题(桂卫Z2010102)

摘　　要：目的探讨改良早期预警评分(MEWS)对急诊就诊患者病情危重程度评估的临床应用价值,减少或避免转送患者的医疗风险。方法对急诊科收治的4 006例患者进行MEWS评分,并根据不同病因联合心电图、休克指数、血氧饱和度(SaO2)检查并进行评分,观察其评分结果与患者预后。结果 4 006例患者MEWS评分最低为0分,最高11分,0～3分2 711例占67.67%,4～7分1 166例占29.11%,8～11分129例占3.22%。0～3分组病死率最低,8～11分组病死率最高(P<0.05)。0～3分组患者转入ICU比率最低,8～11分组转入ICU比率最高(P<0.05)。急性冠脉综合征(ACS)患者、创伤失血性休克、心肺功能不全患者分别应用MEWS结合心电图、休克指数、SaO2评分与单纯MEWS评分比较差异有统计学意义(P<0.05)。结论 MEWS评分联合心电图、休克指数、SaO2评分对评估急诊患者病情和预测潜在危险有一定的临床价值,评分越高,病情越重。Objective To investigate the clinical value of applying modified early warning score（MEWS） to evaluation of disease severity among emergency patients,so as to reduce or avoid the medical risks.Methods MEWS was applied in 4006 emergency patients according to the indices of different etiology combined with electrocardiogram（ECG）,shock index and blood oxygen saturation（SaO2）.The MEWS results and patients′ prognosis were observed.Results Among 4 006 patients,MEWS scoring 0 point was the lowest and the highest was 11 points,there were 2 711 cases whose MEWS scoring 0-3 points（67.67%）,1 166 cases scoring 4-7 points（29.11%）,and 129 cases scoring 8-11 points（3.22%）.The group scoring 0-3 showed the lowest mortality while the group scoring 8-11 showed the highest mortality（P〈0.05）.The group scoring 0-3 showed the lowest rate of patients transferred to ICU while the group scoring 8-11 showed the highest rate（P〈0.05）.Among acute coronary syndrome（ACS） patients or cardiopulmonary insufficiency patients with traumatic hemorrhagic shock,there was significant difference between MEWS scoring combine with the indices of ECG,shock index and SaO2,and simple MEWS scoring（P〈0.05）.Conclusion MEWS combined with ECG,shock index and SaO2 has some certain clinical value for the assessment of emergency patients′ disease and prediction of potential risks;Higher score,severer disease.

关 键 词：改良早期预警评分 心电图 休克指数 血氧饱和度 急诊患者 

分 类 号：R459.7[医药卫生—急诊医学]